Loading...
B-2016-2197CITY OF CUPERTINO BUILDING PERMIT' BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2197 10798 JUNIPER CT CUE ERTINO, CA 95014-6556 (342 57 006) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: CHEUNG ROLAND F AND JENNY TRUSTEE DATE ISSUED: 06/23/2016 OWNER'S PHONE: 650-210-8889 PHONE NO.: (650) 963-5100 LICENSED CONTRA T R'S DECLARATION Lic. #888104 BUILDING PERMIT INFO: License Class _Q -10: C-20 Contractor SOLARCITY CORPORATION Date 12/31/2016 X BLDG ELECT _PLUMB I hereby affirm that I anp licensed under the provisions of Chapter 9 (commencing _ MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Di ision 3 of the Business & Professions Code and that my license is in full force an effect. JOB DESCRIPTION: (N) 9 ROOF -MOUNTED PV SYSTEM (2.34 KW) I hereby affirm under penalty of perjury one of the following two declarations: i. I have and wil maintain a certificate of consent to self -insure for Worker's REVISION # 1 - ADD 1 PANEL (10 TOTAL) INCREASE kW TO 2.6kW - Compensation as provided for by Section 3700 of the Labor Code, for the ISSUED 7/20/16 performance o the work for which this permit is issued. REV # 2 - ADD 11 PANEL (21 TOTAL) INCREASE kW TO 5.46kW - 2. I have and wit maintain Worker's Compensation Insurance, as provided for by ISSUED 8/22/16 Section 3700 If the Labor Code, for the performance of the work for which this permit is issue . Sq. Ft Floor Area: Valuation: $5000.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating o building construction, and hereby authorize 342 57 006 representatives :of this ity to enter upon the above mentioned property for inspection purposes. 0 Ve) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against sai J City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applic nt understands and will comply with all non -point source regulations per he Cupertin' M n cipal Code, Section 9.18. 1$0 DAYS FROM LAST CAL TPECTION. f < Signature Date 08/22/2016 Issued by: MELIS Date: RE -ROOFS: WNE -BUILDER DFJ LARATI N i exempt from the Contractor's License Law for one of the I hereby affirm that I ar following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044 Business & Professions Code) 2. Vas owner of he property, am exclusively contracting with licensed Signature of Applicant: contractors to onstruct the project (Sce.7044, Business & Professions Code). Date: 08/22/2016 1 hereby affirm under p nalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. I have and wil maintain a Certificate of Consent to self -insure for Worker's - -; Compensation as provided for by Section 3700 of the Labor Code, for the performance o the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE a I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6,95 of the Section 3700 f the Labor Code, for the performance of the work for which this California Health & Safety Code; Sections 25505, 25533, and 25534. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that u the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous} shall not employ any person in any manner so as to become subject to the material. Additionally, should I use,equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Q Management District I Worker's Corn laws of California. If, after making this certificate of ,Pty will maintain compliance with the Cupertino Mun'al Code, Chapter 9.12 and exemption, I become Labor Code, I subject to the Worker's Compensation provisions of the must forthwith comply with such provisions or this permit shall the Health & Safety Code, Sections 255 , 255 a4and 25534. be deemed re coked. Owner or authorized agent: APPLICANT CERTIFICATION, Date: 08/22/2016 F certify that I have readthis application and state that the above information is TR LENDINEN Y correct. I agree to comply ly with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building con traction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and leep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature g Date 08/22/2016 - Professional ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 103.00 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a cupertho.org CUPERTIN zot6'��7 EOC ADDRESS ? APN # OWNER NAMEct ��na� _ V� 6 PHONE.. c-5 Fail E-MAIL STREET ADD p *� i ' m� C-4 , C TY, STATEi ZIP 2 Atli©s C1.50� FAX CONTACT NAME cr ��lL� `j_,'`T Yd pts t9�� av�9LV QJ ii PRONE (g r� sp I IJ E-MAIL STREET ADDRESS Qe CI Y, STATE; ZIP fFAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ' El CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑"TENANT CONTRACTOR NAME L g} 1 C'_e LICENSE NUMBER ., O LICENSE TYPE �' a� �' � BUS. LIC # 19 zi L� COMPANY NAME I E-MAIL '� ¢ �L�r C�i g 0�i i }�a , (� ¢ FAX STREET ADDRESS cgt Y, ATE, ZI? o�t � 4-1�j e_� i i C q PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC COMPANY NAMEF-MAIL FAX STREET ADDRESSCITY, STATE, ZIP PHONE USE OF VSD OT Duplex ❑ Muhl -Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: L10111111eYClSl URBAN INTERFACE AREA El Yes El No FLOOD ZONE El. Yes. ❑ NO LH/SOLAR PANELS I 1 ❑ ELECTRIC VEHICLE CHARGING STATION FO SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. i NUMBER OF PANELS/UNITS: `p.°' KILOWATTS (COMMERCIAL. ONLY): 5 -Lf(; TOTAL V,�LUATION: DESCRIPTION OF WORK I� PVApp_2011.doc revised 03116111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2197 10798 JUNIPER CT CUPERTINO, CA 95014-6556 (342 57 006) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: CHEUNG ROLAND F AND JENNY TRUSTEE DATE ISSUED: 06/23/2016 OWNER'S PHONE: 650-210-8889 PHONE NO: (650) 963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class ROOFING Lic. #888104 Contractor SOLARCITY CORPORATION Date 12/31/2016 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: (N) 9 ROOF -MOUNTED PV SYSTEM (2.34 KW) I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's REVISION # 1 - ADD 1 PANEL (10 TOTAL) INCREASE kW TO 2.6kW - Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ISSUED 7/20/16 2. �- I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $5000.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 342 57 006 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understan, s and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cuperti • 0 Muni ipal Code, Section 9.18. 180 DAYS FROM LAS SPECTION. Signature,' Date 07/20/2016 Issued by: MELISS NAME Date: 06/23/2016 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property; or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will: do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code), Date: 07/20/2016 I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2, I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the s. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous hall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Munic�pal�de, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 255, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall r�� be deemed revoked. Owner or -authorized agent: �_%;— - APPLICANT CERTIFICATION Date: 07/20/2016-- 1 certify that I have read this application and state that the above information is CONSTRUCTIO LENDING AGENCY correct. l agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. I understand my plans shalt be used as public records. Signature Date 07/20/2016 Licensed Professional y ALTERNATIVE ENERGY PERMIT APPLICATION CO �NVIWNR Y DE ELOPI'0EW DEPAgIFENT - BUILDMG WASION $ u t R E AVENUE-- - C PIERgTINO,, 5�1,1�J 51014-3y`2`5.5 n Q-2,0 - Z19 �" (40,18) 777-32-28 *' FAX (403) i / i -Ja„ 33 - bulidi IMIW ct�}+eninc,.a PROJECT ADDRESS^� -I (� \ e_y- - APN O - 7 y b� OGVNERNAbiE } �h�1 PHONE n / p�tQ '7 (J GGJJ (( iP Is ® •�-. 911 V -" .® F � � E-MAIL STREET ADDRESS e GpCITY, STATE, ZIP FAX t c '�2Y ' I+iq C' `Sp1 CONTACT NAME � Marjan °avarimard PHONE (_°50.477.6430 E-MAIL mjavanmard@solarcity.com STREET ADDRESS 391 Foster City Blvd L CITY, STATE, ZIP Foster City, CA 94404 mss❑ FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT El CONTRACTOR X CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑. DEVELOPER ❑ TENANT CONTRACTOR NAME Sol arCity Corporation LICENSENUMBEROQ8104 F EYSETYPEC10 BUS. LIC 92334 COMPANY NAME SolarCity Corporation E-MAILmjjaUUvValnmarld@solarcity.com FAX STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PHONE650.477.6430 ARCMTECT/ENGINEER NAME LICENSE NUMBER BUS. LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE l USE OF W SFD or Duplex ❑ Multi -Family PROJECT IN WILDLAND PROJECT N STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE q Yes ❑ NO I9 SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ElOTIfiER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: DESCRIPTION OF WORK , It -VV-- i �.n ke- � ,b 6 pc^c r0 vA Ca.) -� ®( t O) axA . s �. q k, L -j 1 i, By my signature below, I certify to each of the following: I am th2pro erty owner or authorize agent to ac property oti rs behal Is application and the information I have provided is correct. I havf reed t, e Description of Work and verify it is accurate. I agree to comply With all applicable local ordinances and state laws relating to building construction. I t o Iz representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date:.j SUPPLEN ICYTAL INFORMATION REQUIRED F [l 11aA^ r �/ tt! i �% /� ,V .' t 5 i� OFFICE USE ONLY VER-TAECouNTER F ,.� ' ❑ ;EXPRESS U t El STANDARD U t ❑ LARGE P. ❑ MAJOR PVApp_201I.doc revised 03/16/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2197 10798 JUNIPER CT CUPERTINO, CA 95014-6556 (342 57 006) SOLARCITY CORPORATION SAN MATEO, CA 94402 OWNER'S NAME: CHEUNG ROLAND F AND JENNY TRUSTEE DATE ISSUED: 06/23/2016 OWNER'S PHONE: 650-210-8889 PHONE NO: (650) 963-5100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic. # 86 8104 Contractor SOLARCITY CORPORATION Date 12/31/2016 X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: (I) 9 ROOF -MOUNTED PV SYSTEM (2.34 KW) I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $5000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number:. Occupancy Type: and state laws relating to building construction, and hereby authorize 342 57 006 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabili jos, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City ' con uence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant u� erst and will comply with all non -point source regulations per the upe i Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 6/23/2016 Issued by: Abby yende- / Date: 06/23/2016 R-?iI ER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is t. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 6/23/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the a. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devieei)vhich t hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quali anagnt District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Munic'� Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 2550 5533 d 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 6/23/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 6/23/2016 Professional CUPERTIN© ALTERNATIVE ENERGY PERMIT APPLICATION C!iah'UPt[?Y DEVEL0Pf1,lEN1- DE_PAF-Th,AENT • BLjILDIN D1Vi-�;I01,11 ;0:.0_ TGRRF AVEf•JUE: • (`:UPE RTINC), CA 95014.3255 1.10&) 7177-2,228 • FAX (A �8) 777-3,33:2 • buildinq(cDcupertino_org Z-2��� PROJECT ADDRESS j O �P cy- e j • l U r APN k --MAIL OWNER NAME 7� ex\" PHONE EE STREET ADDRESS (o C[TY, STATE, ZIP FAX CONTACT NAME Marjan Javanmard PHONE 650.477.6430 E-MAIL mjavanmard@sOlal'CIty.com STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT ❑ 4RCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAMESolarCity Corporation LIC ENSENUMBER88810 ] LICENSE TYPE C10 BUS. LIC 92884- LUU 'C COMPANY NAME SolarCity Corporation E-MAILmjVaVvvanm'-card@solarcity..com FAX STREET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PHONE 650.477.6430 I ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC K COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: n Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ NO PROJECT IN FLOOD ZONE ❑ Yes ❑ No ❑ SOLAR PANELS I ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELSIUNITS: KILOWATTS (COMMERCIAL ONLY). ) _ TOTAL VALUATION: DESCRIPTION OF WORK Installation (_I_) rooftop flush mounted solar panel ,9,-,3/-) kW RECEIVED BY: By my signature below, I certify to each of the following: I am the ryperty er or authorized agent to act on the property owner's beh lf. I ha a read this application and the information I have provided is correct. I have r 9 the 5p ription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I aut i a sentatives of Cupertino to enter the above -identified property/for//inspection purposes. Signature of Applicant/Agent: Date: C) o9_2, SUPPLEMENTAL INFORMATION REWRED �sY�G� %VV1p 16- OFFICE USE ONLY ❑ OVER -THE: -COUNTER F ❑ EXPRESS U U ❑ STANDARD ❑ LARGE a ❑ MAJOR PV-Ipp_2011.doc revised 03/16/11 CUPER Owner Name _ Address 1. Is your',real ❑ Yes t I? No f Roes your i plumbing, i ❑ Yes: ( No 3. Is water Yes ® No WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building alcupertino.org )perty a registered historical. site? ilCode Sections 1101.1 Through 1101.8 do not apply. to Question 2,. e ;2016 -2_I'F? Skip the rest of the form and sign bottom of form. I property have a licensed plumber certifying that, due to the age or configuration of the property or its allation of water -conserving plumbing fixtures is not technically feasible? it Code Sections 110 1. 1 through 1101.8 do not apply. The licensed plumber's certification has been provided to the Building Division. p the rest of the forin and sign bottom of form. p to Question 3. / ! e permanently disconnected for your building? . it Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. to Question 4. 9,,3/./6 4. Is your, real property built and available for use or occupancy on or before January 1, 1994? No ley real property is built and available for use or occupancy after January 1, 1994. o`'` e, -3- T,/ t Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. El Yes' N ly real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign b ttom of form.. 5. Please check ONE of the following: c, I7 My property is a single-family residential real property. See Civil Code Section 1101.4. ' 3� On and al=ter January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- complian� plumbing fixtures shall be replaced with water -.conserving plumbing fixtures (regardless of whether property dergoes alterations or improvements). ❑ My prop rty is a multifamily residential real property. See Civil Code Section 1101.5. On and aler January 1., 2014, specified building alterations or improvements shall require non- compliant plumbin fixtures to be replaced with water -conserving plumbing fixtures. On or be: bre January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conservuig plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improver ents). ❑ My prop( rty is a commercial real property. See Civil Code Section 1101.5. On and ater January 1, 2014, specified building alterations or improvements shall require non- compliant plumbin fixtures to be replaced with water -conserving plumbing fixtures. On or b fore January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plurnbin fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the ow er or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior r to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 110 ,8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation mquirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the 7ollowing page. Owner or Owrier Agent's Signature:- Date: Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB40 7 2015.doc revised 08126/15 I Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture1 (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate T 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential _ Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals ' Exceed 1.0 Gallons/flush 0.5 gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand' -held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute.@ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets-� Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute C 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi �- Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi i In common and public use areas: 0.5 gallons j per minute @ 60 psi j 1.8 gallons per minute @ 60 psi Faucets —; Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 - Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction, other means may be used to achieve_ reduction. 1. If the fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB40 7 2015. doc revised 08126115 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CU ER`C111`44 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • 'building(Wcupertino.org Permit No. 'D " 2-016-2 d4% Address C -A- # of Alarms Smoke: Carbon Monoxide: PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,.2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide 41arms be installed in the following locations: - Carbon Mo oxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the .State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420;6.2. An electrical permit is required for alarms whi h must be connected to the building wiring. As owner o the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I haves road and aurae in nmmnly with the terms and mndifinns of this :Statement Owner (oi AREA j SMOKE ALARM CO ALARM Outside bedroom(s) of each separate sleeping area in the immediate vicinity of the X X On eveiy _ level of a dwelling unit including basements X X Within eadi sleeping room — X Carbon Mo oxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the .State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420;6.2. An electrical permit is required for alarms whi h must be connected to the building wiring. As owner o the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I haves road and aurae in nmmnly with the terms and mndifinns of this :Statement Owner (oi Owner Agent's) Name: �� Signature ...... - �- � ........................... ...�...--- ............................ Date: ...............:... Contract r Na e: Signature.................................................................. Lic.# ...................................... Date: ................... Smoke and CO form.doc revised 03118114