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CITY OF NEWPORT BEACH
COMMUNITY 'jEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
roject Address:
l(Z Vi11r~ fok-A�- bc.
Permit Number: 2C) — z0 C S
4-Property Owner: 6lehdq Mw\5co
Licensed Contractor: UanLjc#:
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 boxe 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
/beeddrooms with gas fired appliances
IS�LI 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.
I, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further at smoke alarms and carbon monoxide alarms are
prto be f ctional in all the foffowing locations:
re: Date:
NOTE: This se certification is only used for projects to the exterior of the structure where access to the
interior of t, dwelling by the City of Newport Beach Building Inspector is not achieved during the course of
Fortes\SmokeDetectoran4Car onMono.deSelfCert 0811216
CITY OF NEWPORT BEACH
"m
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
r 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
\-Rroject Address:
Permit Number: p—� 2 �y
)� Property Owner: ZU.jz p/ Ali 0 t
Licensed Contractor:
Lic#: lU,SK�l�rt��
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
L 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.
I, 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 tested to a functional in all the following locations:
Signature: (i Date: _'�G
,"�
NOTE: This If -certification is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City of NewportBeach Building Inspector is not achieved during the course of
construction.
Forms\Smoke DetectorandCa GonMonoxideSelfCen 08112 16
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
_ BUILDING DIVISION
' 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
,r
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
_4Project Address
Permit Number.
,4—Property Owner:
C.6 v)\\6k. �)v ivv
Licensed Contractor:
n
Lic #: 1 C IS kcj ;>5i
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
AD 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.
I, 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 a s/tjed to be functional in all the following locations: 42,
Signatureit : 1 Date: if
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
construction.
Forms\SmokeDetectorandCamonMonoxideSelfCert 08/12116
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
Project Address: i o 0 V I L L fl '1)o i IV' T D (; I br -
PermitNumber: NEwJPO?QT 46EACH '12.-6a )C 0-?__0C$
.4-Property Owner: �-I-E S L L-y C:�o N E N
Licensed Contractor: l/, jA 1,7 ""o'?,;•
Lic #: It QCr jlt �,
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:
�Ty 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
/UL 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.
I, 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 tested to be functional in all the following locations:
ll:l �
Date: -�% -t-
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
construction.
Forms\SmokeDetectorandCaMonMonoxideSelfCen 08118 16
YCITY OF NEWPORT BEACH
4 <a
COMMUNITY DEVELOPMENT DEPARTMENT
" BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
-Project Address: U 2 ii" `.
Permit Number. K% D 2O ^ 2 06 S r
,*-Property Owner:
Licensed Contractor:
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:
eCarbon 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
WrzL 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.
I, 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 tes d tob�efunctional in/ all the following locations:
A'S/
ignature: � C I , %t)% r�a� Date: /.2
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
construction.
Fortes\SmckeDetectorandCaMon MonoxideSelfCeR 0811P 16
joe'44, --.
104 VILLA POINT DRIVE, NEWPORT
BEACH, CA 92660
v !'roper=y 0,e•rlei _ LINDA G. GRIEGORIAN
{'7e Statc: of (: sliiuQna H01J% iequivas-.rr- -r-,
nstalled in all rr::sident2Y buildings
f alitornie. Re Jolential f:ode tC7RrC) < tectinri k:r . I. cRc i part that
ex stirny dwelling" be retrofitted with smok- dstur tors rrnr � ins '1"urir,i a tectors-
CRC; Section 2311 A, r'PC R:" 5-3 defines required Icc_,iiou:;.
, 08" boxes ,belsml mu'V ba: r,9ccirr=cS.
j�the rbnr rny or tin al' oritsidc c7fi each s.paste
l 1 -;!r pi .c7 rrc J ii i fi e iri nr i ;f _ du,;ni[y of ber11,<70;nS of in saeh Ndlway outside of
the ;ooms, and rash je�Acl (A tyre dwellir.n, Oc'tectcrs are also required in
�Y6S 4vil yu�'�I rF)fi ;l rll:ilEi rir]Pa
Smoke !harms Installed in each room used for sleeping pruhcses, outside
each sieej7iny rrrr•a, Etnci o^ each level of the dvvr!fnq ,mif
Retrofitted detectors may be battery operated for buildings WhWe no alteraticns are
performed or; the interior. Muitiole-puroose @JLJ rns (carbon monoxide and smoky: ai rms)
shall comply with all applicable: stardards and roust ha approved by the State Fire
Marshall, the df vier;s roust he ills
I, the undersigned, hereby certify that I am the permittec or homeowner of the
project. I inrt er certify that smYe
arms arc! car47on r ronrsxi@e atarris are
presen arrd test .fi ie het rct e \oifoevhrg locations:
Sy Signature' c� Date: —� 7
NOTE 11rrs eLr-cr.Jtrh�c2r!iur; rs 0m:; use for }�n�je .ts to fhc vvxl uor o? :be :rn:r.Jore : ;'au . r:,ess ro r7�ti:
lD env of lh�+ U:'fEi1,'!aQ Dy I1te t'ity Ur rife po B '.il Bjjy6;1rrr; tr!.9pvc'rw i3 )Or aC;,&1"Uo UW7f I,J fim, CCirfS£ iN
Gorisi".vctinn
r�WP°Rr CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
r+± _ BUILDING DIVISION
c9rrF�RHr 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
- - www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be (filled out by the permittee or homeowner)
--Project Address: 1V � ViiC, PO P{-
Permit Number: NCL " ` C FJ (a 25
Property Owner: h G�
Licensed Contractor: CrAn6 Lic #: 10U-L) 2r )
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
L ` bedrooms with gas fired appliances
Smoke Alarms: Installed in each room used for sleeping purposes, outside
Xeach 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.
I, 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 test o g functional in all the following locations:
7
Signature: Date: a 6 I
NOTE. This self-certificatio 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
construction.
FormslSmokeDete torandCarbonMonotd.S.UCert 08/12/16