BLD-2023-0073 JobCard.pdfSMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingtd)cupertino.org
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN
COMPLETED, SIGNED. AND RETURNED TO THE BUILDING DIVISION
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2019 CRC Section R314, R315, 2016 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, R315, and CBC Sections 907.2.11.5 and 420.5 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
bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door)
X
X
On every level of a dwelling unit including basements and habitable attics
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 specified below have been tested and are operational, as of the
date signed below.
Address: "' ' } or) f Permit No. %? S -00
Specify Number of Alarms: # Smoke Alarms: # Carbon Monoxide Detectors:
i nave reaa ana agree to
Owner (or Owner Agent's) Name:
wan me rerms ana conamons or rnls sraremenr t i o oe skgnea oy owner or conrracror
Signature.................................................................................................................. Date:..................
Contractor Name:
Si9na#ure....:.......... r...... c..................................Lic.#........... Date:. �:1:.. ...
Smoke and CO form.doc revised 0711212021
CITY OF CUPERTINO - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
PHONE 408-777-3228 • WWW.CUPERTINO.ORG/ACCELA
JOB CARD
THIS CARD MUST BE POSTED AT A LOCATION VISIBLE FROM THE STREET FRONTAGE ON SITE OF THE STRUCTURE
BEING PERMITTED AND IS NOT TO BE REMOVED UNTIL BUILDING FINAL.
A HARD -COPY OF THE APPROVED PLANS AND DOCUMENTS SHALL BE KEPT AT THE SITE OF WORK.
Permit No: BLD-2023-0073
Building Address: 21067 RED FIR CT Cupertino
Job Description:
NEW 40 GAL WATER HEATER - SAME LOCATION
Issued Date: 01 / 12/2023
Contractor: PLUMBTREE PLUMBING AND ROOTER INC
EVERY PERMIT ISSUED SHALL BECOME INVALID UNLESS THE WORK ON THE SITE AUTHORIZED BY SUCH PERMIT IS COMMENCED WITHIN 12 MONTHS AFTER ITS ISSUANCE, OR IF THE
WORK AUTHORIZED ON THE SITE BY SUCH PERMIT IS SUSPENDED OR ABANDONED FOR A PERIOD OF 12 MONTHS AFTER THE TIME THE WORK IS COMMENCED.
*PLEASE REFER TO QR CODE FOR ANY REVISIONS OR UPDATED INFORMATION