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SELFcERTI'�I SMOKE I CARB MONO
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COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 • buildingrQcuaedino&
PERMIT WILL RE FINALED UNTIL THIS CERTIFICATE IS:
CtlNlpj,FTF,% SIGLE and RETIRN _ TO THE g�IILIiTNG DIVIStUN'
'P�RI'C?5'E• Hance
This affidavit is a w�,�fiCpi for tht� installation of all required Smoke and Carbon Monoxide Alarms for romp
with 2U22 California Residential Codes (CRC) Section R314 & R31e where
nQ interior access for inspections is required.
''t ou may also rant the inspector access into the residence for on -sate verincat�on in 1>eu onoo a p� �,t�5 a�d��''t.
Y �
j�,�C)n site verification of smoke & Co alarms i r it when inspection area is with
r-c�t�+� �r ZNFc)RMATION:and
tin sin le -family and multi -family dwellings shal I be provided withSmoke h { o fb°nodnl fir
Exts g, l�
AAarms must be models approved and listeivisionsl
d by the State Fire Marshal,found
ations uiidin>-materials-listin ml-search-buildin -materials-listin . r � alarms be used hall be
et7 r ic�eer in =-alieu
nd-tnv estt _ permitted
listed in accordance with UL L1'/. ombinan n smoke accordancend carbon with UL 217oandiUL 20334. When thevaluationof additions,
of smoke alarms. Provided they are listed
alterations, or repairs to existing dwelling units exceeds $1,000-00, he CRthe following locations requires that Smoke
alters g
Alarms and/or Carbon Monoxide Alarms be installed an Cot�LAR_�1
A SMOKE
h0KE
1 T .1 12ll1
V\1Ltr�n_ P�
ch slue= ing room- XQa Smoke alarms Shall be installed not less than 2 feet
horizontally from the door or opening of a bathroom that contains a bathtub or shower, from the tip of the
blade of a ceiting-suspended (paddle) fan, and horizontal path from the supply registers of a forced air
heating or cooling system and shall be installed outside of the direct airflow from those registers.
Far additional requirements or clarification see NFPA 72.
p,X every level of a dwelling unit including basements and habitable attics X X
outside each separate sleeping area in the immediate vicinity of the
bedroom(s). X X
NOTE; Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that
do not have an attached garage.
der S� In existing dwelling units with no commercial electrical supplied to alarms, the smoke and Co alarm(s)
may be solely battery operated. In existing dwelling uni I s, alarms are permitted to be solely battery operated where
repairs or alterations dt- not result in the removal of wall and ceiling finishes or there is no am s by means of attic,
basff"t, or crawl space. Refer to CRC Section R314 & R31 . An electrical permit is required for alarms which must be
oraM'dd to the building electrical system.
"As Owner orOwner's appointed agent of the listed property, I hereby certify that the alarm(s) ref raced above are
'nstalled in accordance with the manufacturer's instructions and in compliance with the California Residential Codes,,
80-2 24.0559 ( 22321 Cupertino Road
I br
keae Ga rd;ler
. .._ Date 3/21/2024
Na Master Craft Roof 1t°li).
2'�5j)m�ar,20)22104