B-2016-2861 SMO E / CARBON MONOXIDE ALARMS Fl "L___1 ,,,,,*,
OWN R CERTIFICATE OF COMPLIANCE 6P.
syr, COMMU ITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TelRRE AVENUE•CUPERTINO, CA 95014-3255
(408)77 -3228•FAX(408)777-3333•buildinqcupertino,orq
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PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section 1314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION c
Existing single-family and multi-f 'ly dwellings shall be providedwith Smoke Alarms and Carbon
Monoxide alarms. When the valua 'on of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and C C Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be installed in following locations: 1
G
4REA I SMOKE ALARM CO ALARM
Outside of each separate sleeping'p g area in the immediate vicinity of X X
the bedrooms
On every level of a dwelling unil including basements X X
Within each sleeping room :, X
Carbon Monoxide alarms are not required in dwellings which do nct contain fuel-burning appliances and that
4trbon
iIdo not have an attached garage. monoxide alarms combined with smoke alains shall comply with
CBC Section 420.6 and shall be app oved by the Office of the State Fire Marshal.
I;
Power Supply:In dwelling units wIthno commercial power supply),alarm(s)may be solely battery operated.
In existing dwelling units, alarms allrI--e permitted to be solely battery bperated where repairs or alterations do
not result in the removal of wall anti.ceiling finishes or there is no access by means of attic,basement or crawl
space.Refer to CRC Section R314 and CBCSections 907.2.11.4 and 420.6.2.An electrical permit is required for
alarms which must be connected tthe building wiring.
As owner of the above-referenced '"�roperty,I hereby certify that the;alarm(s)referenced above has/have been
installed in accordance with the in a nufacturer's instructions and in compliance with the California Building
and California Residential Codes_ he alarms specified below have been tested and are operational, as of the
date signed below. I / ( n ,
Address: , . -1 �a t G1. W , c i<—' 'l " fe C Permit No.? i o,b z g 6
Specify Number of Alarms: 41 #Smoke Alarms: I tf ) # Carbon Monoxide Detectors: 1 3 I
I have read and agree to corn y w.h the terms and conditions of this statement
O ner( r• caner A nt's Name:
c Signature Date:PA/40A
r® b ctwt�tw c
Con ractor Nam o
{ `t. 0'e'f� Signature t Lica# Date:
Smoke and CO formdoe revised 09/27/16
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\ \i WATER-CONSERVING PLUMBING FIXTURES patLcs19716rt6
ciksy OWNER CERTIFICATE OF COMPLIANCE
1.iP.,. COMMUNITI'
,. DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPEIRTINO 10300 T0RRE 32 8•AVENUE
4080PER 33Obui d9gC�c p255
- Y ) ertino.orq /
Owner Name " Permit No.
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Address `777-5 L"% L ( --
1. Is your real property a registered histor cal site?
❑ Yes Civil Code Sections 1101.1 hrough 1101.8 do not apply. Skip therest of the form and sign bottom of form.
No Go to Question 2.
2. Does your real property have a licensee plumber certifying that,due to the age or configuration of the property or its
plumbing,installation of water-conserve' g plumbing fixtures is not technically feasible?
El Yes Civil Code Sections 1101.1 1 ough 1101.8 do not apply.
❑ The licensed plumber's 'ertification has been provided to the Building Division.
Skip the rest of the form an sign bottom of form.
No Go to Question 3.
3. Is water service permanently disconnec�t�ed for your building?
Yes Civil Code Sections 1101.1 hrough 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
16 No Go to Question 4.
4. Is your real property built and availabl for use or occupancy on or before January 1, 1994?
❑ No My real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 hrough 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
IY Yes My real property is built an available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 ough 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Please check ONE of the following:
Vr My property is a single-family resid ntial real property. See Civil Code Section 1101.4.
On and after January 1, 2014,buil g 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-
compliant plumbing fixtures shalll, be replaced with water-conserving,plumbing fixtures (regardless of whether
property undergoes alterations or im' rovements).
❑ My property is a multifamily residen`ial real property. See Civil Code Section 1101.5.
On and after January 1,2014,speci ed building alterations or improvements shall require non-compliant
plumbing fixtures to be replaced wit water-conserving plumbing fixtures.
On or before January 1,2019,all noij-compliant plumbing fixtures shall be replaced with water-
conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or
improvements).
El My property is a commercial real pr�perty. See Civil Code Section 1101.5.
On and after January 1,2014,speci i ed building alterations or improvements shall require non-compliant
plumbing fixtures to be replaced wit water-conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the bu lding(regardless of whether property undergoes alterations or improvements).
I,as the owner or owner's agent of this Iroperty,certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above ith water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8,the current California lumbing Code and California Green Building Standards Code,and manufacturer's
installation requirements,and that the ater-conserving plumbing fixtures comply with the requirements as indicated in the
table on the following page. 4
Owner or Owner Agent's Signature: 1 r. fr Date: I 0 If(
24/4*
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
j SB4072015.doc revised 08/26/15
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} BIfILDNG PERMIT CANNOT BEEINALED AND COMPLETED ITIL THIS
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Non-Cornpliant Water-Conserving Plumbing Fixture
Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction)
_� Maximum Water Usage/Flow Rate
Fixture Type 2013 CPC Ch.4 2013 CPC Ch. 4 2013 CPC Ch.4
Water Usage 2013 CALGreen Div.4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3
/Flow Rate _I Single-Family Multi-Family Commercial
Residential 1Residential
Water Closets Exceed 1.6 9 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 G
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. EPAWaterSense 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
Jallow only one shower outlet to be in operation at a time.
Faucets— Exceed 2.2 gallons 1 Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60
Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi
Faucets 0.8 gallons per minute @ per minute @ 60 psi;
10 psi minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
hI 1.8 gallons per minute
@ 60Cpsi
Faucets Exceed 2.2 gallons 71.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60
Kitchen per minute 60 psi @ 60 psi psi
Faucets ay temporarily increase May temporarily
rup to 2.2 gallons per increase up to 2.2
i inute @ 60 psi, and must gallons per minute
(default to maximum 60 psi, and must
1.8 gallons per minute @ default to maximum
II
0 psi 1.8 gallons per minute
/here faucets meeting @ 60 psi
he above are unavailable, Where faucets meeting
erators or other means the above are
ay be used to achieve unavailable, aerators or
eduction. other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usa;ge/flow rate is equal to or lower than the figure shown,it is not required to be upgraded.
SB407'2015,doc revised 08/26/15
u