B-2017-0220CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0220
10334 BRET AVE CUPERTINO, CA 95014-3521 (375 10 036) WESTSHORE
ROOFING INC
SAN JOSE, CA 95131
OWNER'S NAME: REDDY VUSTHLA SUNILAND LATHA KOMMA VIDYA
OWNER'S PHONE: 858-208-8406
LICENSED CONTRACTOR'S DECLARATION
License Class C-39 Lic. #787221
Contractor WESTSHORE ROOFING INC Date 11/30/2018
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.
DATE ISSUED: 02/07/2017
PHONE NO: (408) 456-0200
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REROOF; TEAR -OFF; COMP SHINGLES - (27 SQ)
I hereby affirm under penalty of perjury one of the following two declarations: REV#1 - TEAR -OFF; COMP SHINGLES - (6 SQ)
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.
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.
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
and state laws relating to building construction, and hereby authorize
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
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
Sq. Ft Floor Area: I Valuation: $17940.00
APN Number: Occupancy Type:
375 10 036
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Avende
R&ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature ofApplicar .
Date: 05/09/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF
L 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
permit is issued.
3. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
APPLICANT CERTIFICATION
1 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 and state laws
relating to building construction, and hereby authorize 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 may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Signature
"A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Mu ' i al Code, Chapter 9.12 and
the Health & Safety Code, Se s 25505, 533, and 25534.
Owner or authorized agent:
Date: 05/09/2017
CON TJ KUCT!f�YQNDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Date 05/09/2017 Professional
CUPERTINO
CONSTRUCTION PERMIT APPLI(Q�N
COMMUNITY DEVELOPMENT DEPARTMENT • BUIL I ��{{
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.org 2 0' "' oZZO
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS O 33 L fe �, / /�
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OWNER NAMES 1n 1 I d %^ Q ka
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CONTACT NAME / _ '
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STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ACONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAM e 5�S h _� VvC M V�-
LICENSE NUMBER -7Z -Z
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BUS. LIC #
COMPANY NAME
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PHO _ -O 2-TARCHITECT/ENGINE/-ER
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NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK�
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EXISTING USE
PROPOSED USE CONSTR
TYPE
I # STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? ❑NO
ADDITION? []NO
PRE -APPLICATION El YES IF YES, PROVIDE COPY OF
IS THE BLDG AN[:]YES
RE D
U�
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? NO
❑
1 (
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided i t. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to buil ' con tion. I uthorize representatives of Cupertino to enter the above 'dentif d proyrty for inspection purposes.
'
Signature of Applicant/Agent: Date:
SUPPLE INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER-THE-COUNTER
❑ BUILDING PLAN REVIEW
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS
❑ PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ FIRE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑MAJOR
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO BUILDING Pi
RMIT
BUILDING ADDRESS:
CONTRACTOR:
I
PERMIT NO: B-2017-0220
10334 BRET AVE CUPERTINO, CA 95014-3521 (375 10 036)
WESTSHORE
ROOFING INC
I
SAN JOSE, CA 9513
OWNER'S NAME: REDDY VUSTHLA SUNIL AND LATHA KOMMA VIDYA
j
{
DATE ISSUED: 02/07/2017
OWNER'S PHONE: 858-208-8406
11
�I
PHONE NO: (408) 456-0200
�
LICENSED CONTRACTOR'S DECLARATION
BUILDING PE
T INFO:
License Class C-39 Lic. #787221
Contractor WESTSHORE ROOFING INC Date 1113.0/2018
X BLDG _ ELE
MECH
T_ PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— X RES
ENTIAL COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPT�
iN:
I hereby affirm under penalty of perjury one of the following two declarations:
REROOF; TEAR-
FF; COMP SHINGLES - (27 SQ)
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.
j
> 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: $14000.00
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
375 10 036
!
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 E
is IRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 18
it
DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations p Cupertino Municipal Code, Section 9,18,
180 DAYS +'
I
� OM LAST CALLED INSPECTION.
Signature Date 2/7/2017
I
Issued by: Abby A'
ende
OWNER -BUILDER DECLARATION
Date: 02/07/2017
I;
I hereby affirm that I am exempt from the Contractor's License Law for one of the
j RE -ROOFS:
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
All roofs shall be irisiected
installed without firstbtaining
prior to any roofing material being installed. If a roof is
an in I agree to remove all new materials for
21
compensation, will do the work, and the structure is not intended or offered for
insp n,
sale (Sec.7044, Business & Professions Code)
I, the licensed
-
Signature ofApplic
l
2. as owner of property, am exclusively contracting with
contractors to construct the project (Scc.7044, Business & Professions Code).-
Date: 2n/2017
I
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOT
„COVERINGS TO BE CLASS "A" OR BETTER
r. 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. 1 have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hardous
RDOUS MATERIALS DISCLOSURE
materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Healt
maintain complianc
& Safety Code, Sections 25505, 25533, and 25534. I willI I,
the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
s. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code,
Additiona
ilwith
Section 25532(a) should I store or handle hazardous
I I or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
material.
air contaminants as
y, should use equipment
defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain comp
once with the Cupertin - ' al Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Heal tli
& Safety Code, ons 25505, 33, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
l
be deemed revoked.
Owner or authoriz'
agen .
APPLICANT CERTIFICATION
Date: 2/7/2017
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 and state laws
I hereby affirm that
ROCTIONI ENDING AGENCY
here is a construction lending agency for the performance
Civ C.)
relating to building construction, and hereby authorize representatives of this city
of work's for which t
is permit is issued (Sec. 3097,
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,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
I
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
1 understand my lok
ARCHITECT'S DECLARATION
ns shall be used as public records.
Licensed
Signature Date 217/2017
Professional
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildincl@cupertino.c
PROJECTADDRESS +j12 Z 14 gre'+ AV.
APN#
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OWNERNAMEI I
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FAX
El OWNER 1:1 OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ 1 �CIHTECT ❑ ENGINEER ❑ DEVELOPER El TENANT
CONTRACTOR NA i K
1
LICENSE NUMBER? �7 �y 2 �
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LIG, E T31,11
BUS. LIC. #
COMPANY NAME
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STREET ADDI qr N />r i
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ARCHITECDENGINEER NAME
LICENSE NUMBER S
BUS. LIC. # -
COMPANY NAME
E-MAIL 'ill
FAX
STREET ADDRESS
CITY, STATE, ZIP lig l�
PHONE
USE OF SFD or Duplex ❑ Multi -Family
STRUCTURE: ❑ Commercial
ROOF AREA:
2�
VAL
iV
*: do/b
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINE ES ❑ OTHER (SPECIM
REMOVE /REPLACE BYES
NO
IF NO,
# LAYERS:
PLYWOOD *w, ❑
THICKNESS: ❑ 5/8"
PLYWD ❑ OSB ii
TYPE: CD
PITCH:
:12
ROOF
CLASS: A
II
PROPOSED ROOF TYPE: ❑ BUILT-UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINE
i!
ES ❑ OTHER
ICC -ES REPORT #
y
DESCRIPTION OF WORK: �vw 0 v t coYn
01(\�j o wili la ''; �' d
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By my signature below, I certify to each of the foll ing: I am the property owner or authorized agent to act o ° the property owner's behalf. I have read this
application and the information I have provi is rrect. I hav the Description of Work and verify it is 6curate. I agree to comply with all applicable local
ordinances and state laws relating to bui g tructio a orize representatives of Cupertino to enter the bove-ijentified property for inspection purposes.
Signature of Applicant/Agent: Date: I r TO 4—
SUPPLEMENT-6 INFORMATION REQUIRED
If building is associated with a Home Owner's Association, provide letter
Of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturers Installation Specifications.
Provide signed copy of Cupertino's Tear -Off Policy.
OFFICE USE ONLY
PLAN CHE `K TYPE
ROUTING SLH'
❑ OVER -THE- ,TINTER
0 EXPRESS
❑ STANDARD:: j
❑ BUILDINGPLANREVIEW
❑ PLANNING PLAN REVIEW
❑ FIRE DEPT
❑ OTHERa, ....
i
ReroofApp 2011. doe revised 03116111
II
CUPERTINO
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDINGIll
ISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingg-cupertino
PROTECT ADDRESS) ® 3 f3rill be�vle_,
APN # />�
j ® ,-
P�
OWNERNAME 5tA t,\ i 1�'Q
ql
Prftv
E-MAIL
STREET ADDRESS g Il l
CITY, STATE,FAX
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CONTRACTOR NAME
LIC
ISE.
BUS. LIC. #
COMPANY NA
E-MAIL
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CITY STATE , /�
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I UNDERSTAND AND AGREE TO THE FOLLOWING:
I
1. The re -roof project shall comply with all applicable provisions of t e 2016 California Codes.
1I,
2. An inspection request can be scheduled u to'one business da bel lore the requested inspection date.
Please schedule inspections online or call (408) 777-3228 from 7:3 ! 3:30pm (Mon-Thurs) or 7:30-
2:30pm (Friday) to schedule inspection. For Tear -Off and Nailing )"Ispections, you must also call on the
day of the inspection only after that phase of the work is comple led. The building inspector will be
available within one hour. The hours for this service are: 7:30=10: Pam and 12:30-3:30 (Mon-Thurs)
and 7:30-10:30am and 12:30-2:30 (Friday). Final Inspections will be given a two hour window.
3. Tear -Off Inspection is required. Any and all dry -rotted wood sh' ll be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the (nails/fasteners shall be either
completely knocked -down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required., 11
5. Roofing shall not be applied without first obtaining all prior inspec ion and written approvals from the
building inspector. Any roofing .which, is applied without first obta ning an approved inspection will
require the removal of all new material down to the sheathing so a ;roper inspection can be performed.
6. A Final Inspection and approval shall be obtained from the building inspector when the re -roofing is
completed. To receive a final .sign -off, the following items will be erified:
a. Flat roofs shall have a minimum of I/" per foot of slope ar d demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre-manuf'etured products used shall be
available on-site to review at the time of the inspection. I l
c. Proper spark arrestor installation, vents painted, gutter/da', �nspouts installed, debris removed.
ll
7. NOTE: If you call for a tear -off or plywood nailing inspection andhe work is not complete, you will be
charged a re -inspection fee. The re -inspection fee shall be paid b ore another inspection can be
scheduled.
By my signing below, I certify each of the following is true: I am the property o er or authorized agent to act on the
property owner's behalf. I understand and agree to ly with the re -roof poli stated above. I also understand that
smoke detectors and carbon monoxide deter s are r uired.to be installed in ac; 'ordance with Sections R314 and R315 of
the 2016 California Residential Code.
Signature of ADDticant/Anent: Date:
ReroofPolicy_2014.doe revised 12115116
CUPERTINO
SMOKE / CARBON MONO.:IDE ALARMS
OWNER, CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildino(a)cupertino.org
11�__] i6M1rC3a4_
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2016 CRC Section R314, R315, 2016 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, R315, 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
bedrooms) - (Smoke alarms shall not be located within 3 feet of bathroom door)
—�
rOn every level of a dwelling unit including basements and habitable attics
X
X
Within each sleeping room
_
X�_
_
J
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 ivith
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.
hi 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 which must be connected to the building lATiring.
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 specified below have been tested and are operational, as of the
date signed below.
Address: -0 �j3 y�(i�" Ave Permit No.13: -OZZD
Specify Number of Alarms: -1 r Smoke Alarms: F-57 # Carbon Monoxide Detectors:
Smoke and COform.doc revised 01/10120'
lox
C:UPE.RTINO
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(a)cupertino.orp
Owner Name O_ Permit No. 13iy Z ZO
Address [033y
1. Is your real property a registered historical site?
0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
A No Go to Question 2.
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.
Skip the rest of the form and sign bottom of form.
i No Go to Question 3.
Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No Go to Question 4.
4. Is your real property built and available 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 110 1. 1 through 110 1. 8 do not apply. Skip the rest of the form and sign bottom of fonn.
Yes 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. Check one of the three following statements and sign
bottom of form..
Please check ONE of the following:
My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after 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-
compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether
property undergoes alterations or improvements).
❑ My property is a multifaMily 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 non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ 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 non- compliant
plumbing fixtures to be replaced with 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 building (regardless of whether property undergoes alterations or improvements).
I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving pumbing fixtures comply with the requirements as indicated in the
table on the following page.
Owner or Owner Agent's Signature: _ i - Date: 6,S J (-111 1-701
Upon completing and signing this Cwt rc e, please return it to the Building Division in order to final your bur ding per/nit.
SB4072015.doc revised 08126/15
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB4072015.doc revised 08/26115
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture
(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
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
0.5 gallons/flush
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.
r
I OW ULJ -
LALiGGU L.G VC211UI IO
� c gallons per 'W"Vit in ... ;a 11.5 gal -I ns
IVIQAIIIIUIII I .J I�. QIIVI IJ 1.JGI V Y ILI 1111 UI II LJ. VJ �Uii VilJ per 1111 A11ALV !iJ VV
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
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
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
i
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 existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB4072015.doc revised 08/26115