Lassen County, CA · Lassen County
Self-Certification Affidavit for Smoke and Carbon Monoxide Alarms
Property owners or contractors complete this affidavit to certify required smoke and carbon monoxide alarms are installed at a permitted property.
At a glance
- Issued by
- City of Lassen County · Lassen County, Lassen County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- lassencounty.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This affidavit records an owner’s or contractor’s certification that smoke and carbon monoxide alarms have been installed according to the listed code requirements and manufacturer instructions. The county requires it before final sign-off of permits requiring alarm compliance. It asks for the property address, parcel number, permit number, installed alarm types and counts, and the signer’s date, signature, and owner or contractor role.
Who needs it
An owner or contractor must complete this affidavit when a permit requires alarm compliance and the county needs certification before final sign-off.
How to submit it
Return the completed certification to the Lassen County building inspector before final sign-off of any permit requiring compliance.
About notarization
This affidavit is signed and dated without a notary; it includes the signer’s declaration under penalty of perjury.
How to submit this form
- 1
Download the Affidavit
Download the self-certification affidavit for smoke and carbon monoxide alarms.
- 2
Complete the Property Details
Enter the property address, assessor’s parcel number, permit number, and installed alarm information.
- 3
Sign and Date
The owner or contractor signs and dates the declaration under penalty of perjury.
- 4
Return It to the County
Return the completed certification to the Lassen County building inspector before final sign-off of any permit requiring compliance.
Frequently asked questions
- Do I need a notary for the smoke alarm affidavit?
- No. The document has no notary block; the signer dates and signs a declaration under penalty of perjury.
- Who completes this alarm self-certification?
- The owner or contractor of the property completes it to certify that required smoke and carbon monoxide alarms are installed.
- What information does the affidavit request?
- It asks for the property address, assessor’s parcel number, permit number, alarm counts and types, and the signer’s date, signature, and role.
- How do I submit the alarm affidavit?
- Return the completed certification to the Lassen County building inspector before final sign-off of a permit requiring compliance.