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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: (G73 cxt""_ rTvA L) 4r-N Permit Number: Property Owner: Licensed Contractor: L-bu lam, (ab� Lic #:y -3 Ot 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: LL] Carbon Monoxide Alarm: On the ceiling or wall outside of each separate ping 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. 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: Signature: Date: NOTE: This self -certification is on y 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. 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