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COMMUNITY DEVELOPMENT DEPART YiENT
BUILDING DIVISION
cyr FouN 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 CARBOI9 MONOXIDE
SELF-CERTIF9CATION
(this certification is to be filled out by the permittee or homeowner)
Project Address: 32a�j-,tre
Permit Number: k
K
Property Owner: :na=v Y 5
Licensed Contractor: L Lic #:'�j�
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 bores below must be checked:
Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
V lsleeping 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 manufacturers specifications.
I, the undersigned, hereby certify that I am the permittee or horneowner of the
project. I dasher certify that srn Ice alarms and carbon monoxide alarms are
present an Hi •tested to rye •Function n all the following locations:
Signatur Date: g✓� 2�
NOTE: This self -certification is only used L 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%SmokeDetectomndDarbonMonoxideSelfCert 08/12116