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Building\Building Documents\Forms\PEX Certification 2016 COUNTY OF ALPINE Community Development Building Department Tony Creter, Building Official 50 Diamond Valley Road, Markleeville, CA 96120 Phone: [PHONE REDACTED], Fax: [PHONE REDACTED] www.alpinecountyca.gov PEX CERTIFICATION To: Alpine County Community Development - Building Division From: (Name of Contractor Submitting Plan) (Contractor’s Phone Number) Subject: Request for PEX Pipe Installation for Potable Water (hot & cold) Distribution Date: Alpine County Building Official: As the Administrative Authority under Section 301.3 of the 2016 California Plumbing Code, the attached plan is submitted for your approval per the provisions of this code to permit the use of PEX as an alternate material for potable water use. The PEX product we propose to install is: (Name of Manufacturer) This product has met all criteria for compliance and may be recognized by your department as an approved alternate material for installation on a case by case basis. It is also noted that all installers are trained and certified by the PEX pipe manufacturer. Evidence of each installer’s certification is on file with the installers’ sub-contractor. The installer acknowledges that the potable water system shall be sleeved when placed in soil and flushed twice over a period of at least one week. The piping system shall be first flushed for at least ten minutes and then filled and allowed to stand for not less one week, after which all the branches of the piping system must be flushed long enough to fully empty the contained volume, per CBSC requirements. A tag noting the above flushing requirements shall be attached to each of the fixtures for the owner’s notification. Name of Project: Builder/GC: Permit (Signature of PEX Installer/Contractor): Copies of this certification shall be left on site as part of the homeowner’s notification and filed with the building department.