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B-2017-0703CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0703 10281 LOCKWOOD DR CUPERTINO, CA 95014-2667 (342 30 002) MIKE COUNSIL PLUMBING INC SAN JOSE, CA 95131 OWNER'S NAME: TIMMERS FRANCIS AND DEBRA A TRUSTEE & ET AL OWNER'S PHONE: 989-859-6209 LICENSED CONTRACTOR'S DECLARATION License Class Q -M Lic. #f§7926i Contractor MIKE COUNSIL PLUMBING INC Date 04/30/2019 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: 05/03/2017 PHONE NO: (408) 272-4900 BUILDING PERMIT INFO: X BLDG —ELECT X PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPLACE BUILDING SEWER; REPLACE 40 GAL WATER HEATER - I hereby affirm under penalty of perjury one of the following two declarations: SAME LOCATION 1. I have and will maintain a certificate of consent to self -insure for Worker's REV # 1 - INSTALL BUILDING AND PROPERTY LINE CLEAN OUT; Compensation, as provided for by Section 3700 of the Labor Code, for the TRENCHLESS SEWER MAIN REPLACEMENT performance of the work for which this permit is issued. d'.. 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 C�upe ino Municipal Code, Section 9.18. �''� t Signature tate 5/10/2017 OWNER -BUILDER DECLARATION 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(Sce.7044, Business & Professions Code). 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 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 NT 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. Signature Date 5/10/2017 Sq. Ft Floor Area: I Valuation: $40000.00 APN Number: Occupancy Type: 342 30 002 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ABBY AYENDE RF 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 of Applicant: Date: 5/10/2017 ALL ROOF COVERINGS TO BE CLASS "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 Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505,3, and 25534. Owner or authorized agent: Date: 5/10/2017 17 CONSTRUCTION LENDING 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 Professional GENERAL PERMIT APPLICATION I&J � m Fm P COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1 S A0111L an UCUPERTINO PLUMBING ❑MECHAMCAL ❑ELECTRICAL ❑MISCELLANEOUS (408) 77? -3228 •FAX (408) 777-3333 • buiidinQ(c�cu�ertino.org PROJECT ADDRESS I V •L4� k j ! v _r) r 4PN r OPv'NER NAME ` s ,, f� V` U PHONE &1)'g5 v �� tll ` _ (Z� GJI(` E-MAIL STREET.ADDRE(SSVIJ�')1 �t f7 y� C`: 6CC� FAX j r J� _( �— CITY, STATE,ZP ^Lx� �J �— PHONEt E-MAIL CONTACT NAME l Ri STREET ADDRESS CITY, STATE, ZIP FAX ❑ OH'NER ❑ OWNER-BLILDER ❑ OR'N'ERAGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME yl� % �,� LICENSE 11 MBER LICE? SE f�TE �.p, /% �' O �h BUS. LIC 1 -� > 1 %3 )l COMPANY NAME , r �I l i �r `V , E-MAIL FAX STREET .ADDRESS / ^ , / p „ 1✓. (J CITY, STATE,ZIP Ge� fy, ` `� t PHONE469 �j ARCHITECT/LNGINEERN_AI�E LiCE1:SENti OBER BUS. LI(Cfr COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF FD or DUPLEX ❑ MULTI -FAMILY PROJECT LN 1k ILDL.AND ❑ 'r•ES PROJECT IN ❑ YES BUILDING: ❑ CONA.ER.CLAL LRBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK •�-� / j Q 2L i� O Gl I S e v� ear I A (`e l G`C_C- TOTAL VALUATION O c CSU RECEI\ ED B7 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 bet f. I have read this application and the information I have provided is correct. 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 building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection proposes. Signature of Applicant Agent: Date: SUPPL MENTAL INFORMATION REQUIRED oFTTce USE oNLr , .. ❑ O\ ER -THE COUNTER ❑ EXPRESS v _ U ❑ STANDARD -::1.:,. ❑. LARGE ❑ xWOR A1EPMisc.4pp_2011.doc revised 05/21/11 CUPERTINO SANITARY DISTRICT 20863 Stevens Creek Blvd #100, Cupertino, CA 95014 Tel (408) 253-7071 • Fax (408) 253-5173 SPAITAgT,D,r fsr'4BLISStU ��'CUPERTINO SANITARY DISTRICT PERMIT LETTER Cupertino Sanitary District has adopted Resolution No. 1263. Building Permit Request (Over -the -Counter) Single Family Project ❑ Multi -Family Project ❑ Commercial Project Project Address: 10'—'51 L—oc -ujo-o7 'D 2. -Aptj '-2-) 4 -2 002 Permit Number: ?o --m+- OTC3 Scope of Work: Owner/Applicant Name: _0n 4- oDs�- 2- 72 - 4,q o d Address: a�o LA Date: l� �� Prepared By: Cik Authorized Representative /, as property owner or authorized agent, acknowledge that all Cupertino Sanitary District requirements will be met and a// required fees will be paid prior to the approval of final inspection for proposed project. Date: -5/l2Q Signature:11 ner / Aut6orized Agent CUPERTINO SANITARY DISTRICT OFFICE USE ONLY ❑ Pre -inspection Required Final Inspection Required Date Scheduled: Date: Conditional Approval By: Authorized Representative Cupertino Sanitary District District will notify owner of the required fee within 5 days after Pre -Inspection has been completed and cc City of Cupertino. Inspection Fee Paid Date Paid: �5- 10-1-7 Insp9ptibn Fees: $250/unit - Single Family Residential already connected, but new cleanout is required O $150/unit - Single Family Residential already connected with existing cleanout in working order D $350 Minimum — Commercial and Retail Actual Amount: D $200/each — Disconnect and/or abandon lateral service Connection Permit Fees: D $350/unit - Single Family Residential connecting to existing lateral D $650/unit — Single Family Residential connecting with new lateral D $100/unit — Multi, Hotel, Living Units, etc. Actual Amount: D $500/connection - Commercial and Retail Actual Amount: Connection Use Fees (See Attached Calculation Sheet): Area and Frontage Fees Amount: D Residential Excess Fees over 3.5 unit/acre Amount: Commercial and Retail Connection Fees Amount: Commercial and Retail Change in Use Fees Amount: Date: - I o t7 Final Approval By: Authorized presentative Cupertino Sanitary District CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10281 LOCKWOOD DR CUPERTINO, CA 95014-2667 30 002) CONTRACTOR: PERMIT NO: B-2017-0703 (342 MIKE COUNSIL PLUMBING INC SAN JOSE, CA 95131 OWNER'S NAME: TIMMERS FRANCIS AND DEBRA TRUSTEE & ET AL DATE ISSUED: 05/03/2017 OWNER'S PHONE: 989-859-6209 PHONE NO: (408) 272-4900 TENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36 Lic. #679261 Contractor MIKE COUNSILPLUMBING INCDate 04/30/2019 X_ BLDG —ELECT X 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: I hereby affirm under penalty of perjury one of the following two declarations: REPLACE BUILDING SEWER; REPLACE 40 GAL WATER HEATER - 1. I have and will maintain a certificate of consent to self -insure for Worker's SAME LOCATION j 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. i APPLICANT Sq. Ft Floor Area: Valuation: $40000.00 CERTIFICATION I certify that I have read this application and state that the above AFN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 342 30 002 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 this permit. Additionally, the applicant understands and will comply with all ll non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 05-03-2017 Issued by: Kim Dunbar OWNER -B TIT D R DECLARATION Date: 05/03/2017 I hereby affirm that I am exempt from the Contractor's License Law ;for one of the a RFcROOFS: 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 (Scc.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 05-03-2017 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 AL • 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 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 Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 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 the Health & Safety Code . Sections 25505, 25533, and 25534. be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 05-03-2017 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. Signature Date 05-03-2017 Licensed Professional GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION =EL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1 S CUPERTINO (408) 777-3228 • FAX (408) 77-3333 • buildina(c�cu�ertina.ora I\IIPJ.Irn�nrlrr �r,rcnr,.w.,�.. li___- 13 2,��" - PROJECT ADDRESS j /' 0 L a„ j W,10� ✓ C IJbLtC IKiC AL LJMISCELLAI�TEOUS � �N 31 (lJ t! r7fL �y 3 y Z C 66 OSTERNAlg��[`� l� {� PHONE ��� _ %(i� E-MAIL (� CITY, STATE, ZIP( �� " v 1 FAX �, STREETADDRESS / �l � 0 0d �'� [ SJ `I CONTACT NAME PHONE E MAIL I CITY, STATE, ZIP FAX STREET ADDRESS ❑ OWNER ❑ OWNER -BUILDER ❑ WVNERAGENT ❑ CONACTOR )J CONTRACTORAGENr ❑ ARCHITECT ❑ ENGLNEER ❑ DEVELOPER ❑ TENAN*T CONTRACTOR NAME i f A k LIiCENSE NUMBER —y(; y (b LICENSE TYPE f� BUS. LIC r g COMPANY NAME g j�-CJQ //,l�t�rf ` pt to ��L �.X✓"Ilg5c t�j E-MAILEMAI t>`r"vl Qr ✓Y't �p6 ��? (/,?�j FAX STREET ADDRESS CITY, STATE, ZIP�e 3 PHONE ,a Q Z� Nay ARCHITECT/ENGINEER NAME LI ENSE NUMBER BUS. LIC COMPANY NAME E-MAIL I FAX STREET ADDRESS CITY, STATE, ZIP PHONE v USE OF SFDor DUPLEX El MLiLTI-FAMILY BUILDING: ❑ COMMERCIAL PROJECT LRT AIII.DLANU URBAN INTERFACE ❑ 'YES AREA NO PROJECT IN ❑ YES FLOOD ZONE ❑ IS THE BLDG AN ❑ }Tzs � ❑ NO EICHLERHOME? ❑ NO DESCRIPTION OB IVORK�y _'" aAAj A TOTAL VALUATION: D " By my signature below, I certify to each of the following: Iain the property application and the information I have provided is correct. I have owner or authorized agent to act on the property owner's behalf. I have read this l the Description read ordinances and state laws relat*m.to buil ' g construction. I authorizc of Rork and verify it is accurate. I agree to comply with all applicable local representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: / o S PPLEMENTAL INFORMATION REQUIRED = OFFICE USE ONLY.:...::-., 77 01ER-THE COiJl\TER I ' x FA EXPRESS _ U STAnDARD z © LARGE AZ' JOR A7EPA1iscApp_2011.doc revised 05/21/11 SMOKE I CARBON MONOXIDE PL ANCE ALARMS OWNER CERTIFICATE AO M CT •BUILDING DIVISION COMMUNITY DEVELOPMENT CUPERTINO, CA 95014-3255 10300 TORRE AVENUE • . building(c-Dcupertino.o>r (408) 777-3228 FAX (408) 777 3333 -Ls for arn nox PURPOSE the installation of all required Smoke and Carbon Where no interior access This affidavit is aself-certification for 2016 CBC Sections 420.6 and 90 compliance with 2016 CRC Section 8314; 8315, for inspections are required. GENERAL INFORMATION Q is exceeds ti-famil dwellings shall be provided with s o exi sting dwellinb ms and Carbon Existing single-family and mill Y noxide alarms. When the valuation of additions, alterations, or repair VIo � C Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or i and CB $1000.00, CRC Section 8314, R31o, SMOKE ALARM CO ALARM Carbon Monoxide warms be installed in the following locations: X �- AREA X outside of each separate sleeping area in the immediate vicinity of the O X X om s — (Smoke alarms shall not be locatedW ntsanahabitable attics door X bedro () unit including bas _----- On every level of a dwellin Within each sleepincr room appliances and that got required in dwellings which do not contain ke alamss hall comply with Carbon Monoxide alarms are i q t have an attached garage• Carbon monoxide ffice of the State combineFire Marshal. do no roved by the CBC Section 420.6 and shall be app alarms) maybe solely battery operated. power Sup ly: In dwelling units nth no commercial power supply, operated where repairs or alterations do Po . p basement or crawl ling hiushes or there is no access by n1eermit is required for In existing dwelling touts, alarms are permitted to be solely battery o not result in the removal of wall and ce space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical alarms which must be connected to the buildi'ig wrong• alarms) referenced above has/have been , I h instructions and compliance with the California Building As owner of the above -referenced propac�t I hereby certify that the -id are operational, as of the installed in accordance �•�nth the s. The Residential Codes. The alarms specified below have been tested ai and California Permit date signed below. C/4 // Address: ( �WZ r Smoke Alarms: Carbon Moiio?:ide Detectors: Specify Number of Alarms: _ to comply with the terms and conditions of this statemen I have read and agree ` .. Date: ........ /,•. . ame: I ....................................... Ow r (or Si -nature.... . � Date:....�16.... �• ,� to �...!........................ v ... ic.M .......... . Contractor Name: .<............:........................... Signature.. .......... ` Smoke and COfonn.doc revised 01/10/=01; WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE 1 1j I COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTIINNO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 Owner Name Oe—lora I ( ell v"ev 'S Permit No. 5— 2c 1 4- -0_4o3 Address / 0 2 b l LUCcI,iyUct 1/3 i, ,�_�uc 0 � %Cc's PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIC-NED AND RETURNED TO THE BUILDING DIVISION 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? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form Owner' Signature:�ah4�/�;� Date: N 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. Sign below and skip the rest of the form Owner' Signature: da, 1- Date: / � No Go to Question 3. `° /5 /� 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 djrou t apply. Sign below and skip the rest of the form Owner' Signature: rim"'— GI-� Date: % 3 No Go to Question 4. b 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 1101.1 through;,1101.8 do not apply. Sign below and skip the rest of the form Owner' Signature: �{ �_. Date: Vr � 7 I� 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. Refer to the attached. F9 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. SB4072014.doe revised 03/18/14 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/We, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures have been replaced 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 plumbing fixtures corrigly with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature: Date: 6, 11&4— Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 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. SB407 2014.doc revised 03118/14 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /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 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. Faucets — Exceed 2.2 gallons 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; 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 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. SB407 2014.doc revised 03118/14