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B-2016-2420 DocuSign Envelope ID:8513D1DD-C464-4705-AODD-2429380A3C44 4E1 \� l WATER-CONSERVING PLUMBING FIXTURES• ❑ ; ❑ *, OWNER CERTIFICATE OF COMPLIANCE QST t�, COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•bulldinaOcuoertino.org Owner Name Mohanan Cha Permit NoYom-- \ Address 7497 Rollingdell Dr, Cupertino, CA 95014, US (SANTA CLARA County) . P RMI'C CANNOT`BE FINALEi3 AND COMP ,ETEi?'IJ TIL HIS C.I RTII+'ICATE AAS BEJIN S.If;NFD RT+.1Tt�1) O T111 Bu ILDI G DI1 ISION Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. - 1. Is your real property a registered historical site? O Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the test of the form. —DocuSigned by: Owner'Signature: Aukatoutt& aka Date: 7/25/2016 DI No Go to Question 2. `—33B 83AC321 BE48 E... 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? © Yes Civil Code Sections 1101,1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. —Docusigned by: fl a ,..,( owner'Signature: �(,b ,pu, t Date: 7/25/2016 L1 No (3o to Question 3. L-33B83AC321BE48E... 3. Is water service permanently disconnected for your building? DI Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. c—DocuSigned by: Owner'Signature: iltdutiA4A, CLALit Date: : 7/25/2016 11 No Go to Question 4. `-33BB3AC321BE48E... 4. Is your real property built and available for use or occupancy on or before January 1,1994? O No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the test of the form. &battouttet, euSIgnad by: Owner'Signature ( Date: 7/25/2016 Yes B83AC321BE48 .. My 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. Refer to the attached. IR My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014,.building alterations or unprovements 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-compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures(regardless of whether property undergoes alterations or improvements). 0 My property is a nrrult family residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all noncompliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless ofwhetherproperty undergoes alterations or Improvements). I] My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require nen-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. SB407 2014 doe revised 03/78/14 DocuSign Envelope ID:8513D1DD-C464-4705-AODD-2429380A3C44 ❑ ., ❑ SMOKE!CARBON MONOXIDE ALARMS -- OWNER CERTIFICATE OF COMPLIANCE 400 I COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPEt TMC! 10300 TORRE AVENUE.CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildineOculaertino_org Permit No. 2 o T6 2 Y2.o Address 7497 Rollingdell Dr Cupertino,CA 95014 (#afAlarms(Smokex (Carbon Monoxid• e X :P T C N OT_BE F1t�T�iLED:AND Ct}MF1.�E` 'EI)UNTIL THIS CER 1k'ICA1'E==::' .ri-iC 1+. a 'I�°�a l� _•:4��:Jk�•. _�t+.7i'u/11.tiyr."JJi►:3b.1Lb!1?I'*;•:-`��e�';:^`-- -�=��:_s� _ -.:tet•-`_;..... _ _ .J-moi+-� 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-familydwellings 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 Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroonn(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-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 wail 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 which must be connected to the building wiring. As owner of 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. l have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: "—met/signed by: Mohanan Chalii (slur .... ` . &.. t (I ) 7/25/2013 Contractor Name: 4°.—..33B83AC321BE48E... Signature Lic.# Date: Smoke and COform.doc revised 03/18/14