B-2016-2514 STOKE / CARBON,MONOXIDE ALARMS
T. OWNER CERTIFICATE OF COMPLIANCE
Ap, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
E t 10300 TORRE AVENUE•CUPERTINONO ,CA 95014-3255
CUP (408)777-3228•FAX(408)777-3333 r building a(,,cupertino.orq
Permit No. 'a aC3 y 15 c5 i*-
Address ( 0 ck a-S CaL, a, it t' b— 0- r #of Alarms Smoke: A- Carbon Monoxide: a.
PERIYIIT CANNOT BE FINALED 4AND COMPLETED UNTIL TATS CERTIFICATE
BIAS SEE=l �T[tN[D A111➢j2ETURNI D4OYTHE BUiLDINC:1 [ ISI() (
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PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION '
Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions,alterations, or repairs to existing dwelling units exceeds
$1000.00,CRC Section R314 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 _
Outside of each separate sleeping area in the immediate vicinity of the X X
bedroom(s)
On every level of a dwelling'unit including basements X X
Within each sleeping room - X
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 has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes.The alarms have been tested and are operational,as of the date signed
below. ,
I have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name: p
Sb�,n1z0'r I-c. -s�nncurl Signature ....P.t -� Date: to.J..�..�.�...:
Con rector Name:
ciNi i Aj/3 d_ Ca !I 6'
j✓" Lt�/ �G Lic.# 79(1- e.V e7 le Date: l�'`�✓
Signature..... ..
Smoke and COfonn.doc revised 03/18/14