BLD-2023-2814_SMOKE/COJ J�J
z
r
r
L
I
C
SMOKE / CARBON MONOXIDE ALARM
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingCc�CupertinO.org
J
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN
jJRNE TO THE BUILDING DIVE ION
COMPLETED, aI =N "D, AND RE
PURPOSE smoke and Carbon
s for
fication for the installation of all required420.6 and 907.211#2 whereno in er Monoxide or a
This affidavit is a self -certi c ess
compliance with 2016 CRC Section R314, R31512016 CBC Sections
for inspections are required.
GENERAL INFORMATION
shall be provided with Smoke Alarms and Carbon
Existing single-family and multi -family dwellings
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314, R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or
Carbon Monoxide Alarms be installed in the following locations:
AREA SMOKE ALARM CO ALARM
X X
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door) X X
On evely level of a dwelling unit including basements and habitable attics X
Within each sleeping room
Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above hasihave been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms specified below have been tested and are operational, as of the
date signed below.
Address: '1010 () Permit No
Specify Number of Alarms:
# Smoke Alarms:
I have read and agree to
Owner (or Owner Agent's) Name:
5L)LI.tV14-.JIV,
Contractor Name:
# Carbon Monoxide Detectors:
with the terms and conditions of this statement
....... ................. ...................... ........ ]Dat:. r< -.... ...
nature...................................................................... Lic.#........................................ Date:................ .
Smoke and CO form.doc revised 01110,,12017
:RY PERMIT ISSUED SHALL BECOME
IF THE WORK AUTHORIZED ON THE SITE gY SUCH PERM Date Dec z1' 20z3
INVALID UNLESS THE
WORK ON THE SITE AUTHORIZED
IT IS SUSPENDED OR gggNDO gY SU
OR CH PERMIT IS MME
ON F A PERIOD OF 365 DAYS
"""Ply with all non -pint
A