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CITY OF NEWPORT BEACH
CONIMUNPTY DEVELOPMENT DEPARTNEENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1(949) 6443200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be fitted out by the permittee or homeowner)
Project Address: 449 3 r4go A -y
Permit Number: 2-&C-16— OZZ1
Property Owner. r� M0,5 Tile Sc
Licensed Contractor: FN ?Q05 Lic
The State of California now requires that smoke and carbon monoxide detectors must be
installed in all residential buildings
California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that
existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors_
CRC Section R314.3, CRC R315.3 defines required locations.
Both boxes below must be checked.
Carbon Monoxide Alarm: On the ceiling or wall outside of each separate sleeping
area in the immediate vicinity of bedrooms or in each halfway outside of the rooms,
and each level of the dwelling. Detectors are also required in bedrooms with gas
fired appliances
Smoke Alarms: Installed in each room used for sleeping purposes, outside each
sleeping area, and on each level of the dwelling unit.
Retrofitted detectors may be battery operated for buildings where no alterations are
performed on the interior. Multipurpose alarms (carbon monoxide and smoke alarms)
shall comply with all applicable standards and must be approved by the State Fire
Marshall. The devices must be installed per manufacturers specifications.
1, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further certify that smoke alarms and carbon monoxide alarms are
present and "d to be functional in all the following locations:
Signature: 1 V / �/yY l ��� i- Date: 1(IIW R
NOTE.' This self-certificafton is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of
constnrction.
FO mslSmokeOeixWMndCWbonMono)ddeSeOCed 09111114
423 Full"ft AMC.
CITY OF NEWPORT BEACH
CONIMUNTM1 DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1(949) 6443200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this ceriftation is to be filled out by the permittee or homeowner)
Project Address: `id 3 kv l le 14(mv
Permit Number. fiC G I — o ZZ l
PropertyOwner
Licensed Contractor: 'fi9-0.5 Lic*: 102_ZSiz
The State of California now requires that smoke and carbon monoxide detectors must be
installed in all residential buildings
California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that
existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors_
CRC Section R314.3, CRC R315.3 defines required locations.
Both boxes below must be checked.
Carbon Monoxide Alarm: On the ceiling or wall outside of each separate sleeping
area in the immediate vicinity of bedrooms or in each hallway outside of the rooms,
and each level of the dwelling. Detectors are also required in. bedrooms with gas
fired appliances
Smoke Alarms: Installed in each room used for sleeping purposes, outside each
sleeping area, and on each level of the dwelling unit.
Retrofitted detectors may be battery operated for buildings where no alterations are
performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms)
shall comply with all applicable standards and must be approved by the State Fire
Marshall. The devices must be installed per manufacturer's specifications.
1, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further certify that smoke alarms and carbon monoxide alarms are
present andel told to b9 functional in all the following locations: c5'
Signature: 1 G / l/1) \ Wiz- Date:
NOTE.' This self -certification is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of
conshuction.
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