15110115 SMOKE/WATER SMOKE l CARBON MONOXIDE,ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT=BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 90014-325
(408)777-3228 FAX(408)777-33113;:buiidingtoDcupertino.ora
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Address ��� ��� +
�` �f`01 E iY o€ ��� �zz�o�e• J- Carboa monodide PERMIT CAINTINO`;. BE FINIED ND CO'TN PEETEI3 UNTIL THIS CERTIFICATE
HAS BEENN S LrN_EII AND RE 2L'&N�D T4 THE BUILDD4G DIVISION
pURPOS
T'lds affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2023 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
GENERAL INFORNUTION
Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and.Carbon
Monoxide alarms. When the valuation of addidons, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section 22314 and CBC Sections 907.2.11.5 and 420.6 require that Sinoke Alarms and/or Carbon
Monoxide Alarms be installed in the following locations;
SMOKE ALARM, CO-A.-LAR-ML
Outside of each separate sleeping area in the immediate vicinity of the X X
bedroom(s)
on every level of a dwelling unit including basements X X
Within each sleeping room X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burniiig appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CIBC Section 420.6 and shall be approved by the Office of elle State Fire Marshal.
Power Supply:In dwelling units with no commercial pcvver supply, alarms,may be solely battery operated.
_._, existipg dwell ng units, alaare permitted to be solely battery operated where repairs or alterations do
_ - _�
not result in the removal of}wall and ceiling fis- isizes or there is no access by means of attic,basement or gra;tel
space_Refer to CIRC Section R314 and CBC Sections 907.2.114 and 4_20.6.2.An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above-referenced property,T hereby ce ti y that the alarm(s)referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with.the Califor--Tda Building
and California Residential Codes.The alarms ha-vre been tested and are operational as of the date;signed -
below.
I have react and ac ree to cornply with the terms and condiiians of this statement
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Smoke and Coform.doc revised 03/1-3,14
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-CON'F:PVING PLUMBING FIXT UR�S
MATER OWNER CERZ�—
-IFICATFE OCOMPLANCE
1
COMM UN[7'-,'ID,EVELOPMEN-1 DEPARTMENT- BUILDING DIVISION
A
InA
OOTORRE VENUE-C'UPERTIN1,10,C 9.50�A
CURERTHNO rl� i-3255
(408)---7-3228-FAX(408)777-3333-bufldinaO�7_cimentino.orq
--i
O-w:ner Name Y1 Fe f �,j U T(AlAr 2F-A-16 Pyr reit 0.
Address<?KD71 53 Par'T-n-, \11 Oxlo�
1. is your real propefty a site?
�71's Civil Code Sections 1 101.1 tbrough 1101.8 do not apply. Slap the rest of the fort and sign bottom.of fonx,
o Gh to QuesdOri 2.
2. Does your real property have a licensed plmimber certiliyIng that,due to the age or configuraTion or Inc nrov(�,rtv or
-s
plurnbing,installation of water-conserving,plumbing Ext,-,res is not technically feasible?
0 Yes Civil Code Sections 1101.1 through 1101.8 donot apply.
0 The licensed plumber's certification has been provided to sue Building Division.
Skip the rest of the forra and sign bo-Lto m of fort'_.
-No Go to Question 3.
Is water service
' 1)crnaaaently disconnected for your building?
L
0 Y es Civil Code Sectio-:11s 1101.1 through 11101.8 do not applySkip the rest of the forra and sign bot om of fon-.
11 No CTO to Question 4.
4, is your real property built and available for use or ocmxpancy on or before January 1, 199A
F-
i No My real propertyisbuil--t
and available for use or occupancy e1-January 1, 1994.
Civil Code Sec rions 1101.1 1-ough 110 1.8 do net apply. Skip the rest of the forrn and sign b0 of
Yes My real property is built aid available lable Rur use or ormumancy on or b re January 1.1994.
T' -llo-,ving smtemeniq anG S1,
g! I I g:1
CrVil Code Sections 1101.1 'thro-a, i 11 113-1.8 apply. Check one o�P t:h-,---cc fb
bottom of foi—..-.
5. Plea-se cheolk OINTE of the following:
E-, JMy property I's a single-fannily residential real provert;. See Civil Code Section 1101.1.
On and after January 1, 2014, building alterations or inmi, rovernes-a-U-3 shall recrm-'-t all non-conmliailll phnnbLng Extures
to be replaced with wate-,consc-.i-vLTicy plumbing f,7-tL,-T-es tt-arougho-at the building.On or before January 1,2017, all non-
i; pluinb-incr fi--tares s--all. be replaced with wattr-consc-rvuicr 5 ',-, cs [re, ss of' -%��,hethe-
gardle
property undergoes alterations or ur-prove-ments).
Y-11 y prois
property. See Civil Code Se-.ton 110' x.
On and after Januax%!1, 2014, specified building alterations or irnprove-m-Lents shall. re r qu' t,
e 11021-Com' 'ID11an
plumbir-a Extures to be replaced vvilh rater-conservirig plumn'bing fix-:-res.
On or bef-aza Ja--:ua-. q,hah b(-:�rei3lact-d with watc-r-
y 1� 2019,all non-com plinmt plumbin�fli,I--e
out re _-o
conser,i g plumb- ing fixtures through t[i--'-m;ldJ-r.gf
improvements). ti
El I'vily pro pe-mris a comm ercicJ real property. Se e Civil Code S,--,t--'-On 1101.5,
On and after Jana-ly 1. IN 11-4,spec_ ed building alterations or maproveTnents shall require no.-n-co=l'
Hant
plurnbing fixt,mares to b-=replaced vvi t water-rooms---ging plu.mb in 9 L,XMI res.
On or be-fore January 1, 2019, all non-cor-n-pliart -plurnbling fimturts shall be replaced with water- conte el-ViTIE
plum-binc,Ext res thiroi-igHout the building(regardless oEv,' r property undergoes alterations or irnproveme ts).
I.as the owner or owner's age--int o fL tlm-s property,-,erti fy under Pena ll I:;of T)cri ury that:aon�corml antJ1 -bin C7 fixtarts will be
replaced prior to da!=specir"I'-d.above with vatcr-conser-"ing-D-11-amc,b-imfixt-,rics inac-cordanct wi-ith Civi. Code S ec-L07—
though, 1101.8,Lie c=�,t California Fbx-rb-.-.-2 Code and Ca T fomia Green BuildinR Standards Codeand rnanuffacturer -z
com ply wi h req-d' cl-11,C121s as Indicatt-d in.--he-
installation rquirerncnitzs, and that tilt.veja-;1q-,-1onstrVL'n2 plurnibing xP res
table on the follow ngPa:91c.
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Owner or Ow—r_ geffs Sitgnatu D
um,o-n co_spieling and signi -L'h--',c-Cert;=Rcate.p, ase r nirr, na I
MJ,L it to'-I-c P-al din R D �--:,`on-in(D 1-10 ud-i
do -e -6114�
�,3;1!if 26 r c i wised U 11-2