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X20711ql1
122 �Swadc �
CITY OYNEWPORT-BEA
COMMUNITY )�E CH
T DEPARTNMNT
BUILDING DIVIAiON .
3300 Newport Boulevard I p.0. Box 1768 1 Newport Beach, CA 92658
mAw.neWporlbeachda.gov.1 (949) 644-3275
SMOKE DETECTORAND CARBON M . ONOXIDE
SELF -CERTIFICATION
(this certification
is to be filled out by the permittee)
Project Address:
Permit Number:
Property Owner:
Licensed Contra
The State of California now requires. that
installedsmoke and carbon
in all residential buildings
rdonoxide detectorsmustbe
California Residential Code (CRC) Section R31411. CRC R8,15.2 states in part .that
existing dwellings be .'retrofitted with smoke. 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 Qmd Doq
3 defines required locations.
's
Both below must be checked.
ol
5.
Carbon Monoxide Alarm: On the ceiling .or wall outside of .each separate sleeping
70a in the immediate vicinity of bedrooms'or in each. hallway I outside of the rooms,
,pnd each level of the dwelling. Detectors ar
fired appliances e.. al soirequired in bedrooms with gas
Smoke Alarms: Installed imeach room used for sle
eping purposes, outside each
sleeping area, and on each leverof the dW611ing unit.
Retrofitted detectors may be battery operated forbuildings where no alterations are
performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke.alarms)
shall comply with all applicable standards and most be approved by the State Fire.
Ma . rshall. The devices must be installed. per manufacturer's: specifications,
1, the unders loned , hereby certify that am the permittoe of. . the project. (:furthercertify that ,�Mui�e alarms aPd�ca?boh monoxide Wo alarms. are present and testedto
be functional in aW the folloWind-innnflAne.
Signature:
NOTE: This self-cert/ficationlis only used . forprojects to the ext6flor of:the structure here access totheinterior of the dwelling by the City of Newport Bea W
construction, ch Bulldlng:lnsoec�tor Is not achieved during the course of
FormslSmokeDelectorandCarbonMonDxideS6lfCoa 08/03/11