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Project Address
Permit Number:
Property Owner:
Licensed Contra
xzolq _z,qg
>5 incore U
CITY OFNEWPQRT-BE 1CH
COMMUNITY DEVELQPM NT DEPARTMENT
BUMMING ElMgjON
3300 Newport Boulevard l P.O. Box 1768 1 Newport Beach, CA 82658
www.newportbeachda.gov.1.(949) 64473275
SMOKE DETECTOR;AND CARBON MONOXIDE
SELF -CERTIFICATION
(th/s certification is to be filled out by the permittee)
The State of California now requires that.smoke and carbon m
installed in all residential buildings onoxide detectors must be.
California Residential Code (CRC) Section .'R314.1, CRC 'R3'15.2 states in' pan .that
existing dwellings be retrofitted with .smo.ke. detectors and carbon monoxide detectors
when a building permit is issued for, work or repairs to a building that is valued at $1,000
or more." CRC Section R314.3; CRC. R315.3 defines required locations.
Both oxes below must be checked:
Carbon Monoxide Alarm: On the
g orrea in the immediate vicinity of bedrlooms or nlleach hallway outsideaof the rooms,
,and each level of the dwelling. Detectors are. also
fired appliances required in bedrooms with gas
Smoke Alarms: Installed in:each room used for. sleeping purposes, outside each
sleeping area, and on each ie -vel of the dwe.ling 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 `andmust be approved by the State Fire
Marshall. The devices must be installed.per manufacturer's specifications.
1, the undersigned ereby certify that 1 am the permittee of the project. i :further.
certify that smok al rms and c on monoxide alarms are present and tested to
be functional in al .the .ollowing l .cations;
Signature:
Date.,
NATE: Th/s self cerhficabon is only sed for protects to th'e exterior of the structure Where access to the
constr con.ofstruction.
the dwelling by the Clty of ewport Beach BVi/d/ng,lnspector is not. achleved during the course of
construction.
FormslsmokeDetectorendCarbonMonoxideseffoerl'DA[03/1a'