Rialto, CA · San Bernardino County
Self-Certification and Verification Form
Property owners use this form to verify smoke and carbon monoxide alarm installation and testing, and compliance with water-efficient plumbing fixture requirements.
What this form is
This form lets a property owner verify that required smoke and carbon monoxide alarms are installed and working, and that plumbing fixtures meet the stated water-conservation requirements. The form describes these requirements in connection with permitted alterations, repairs, or additions to existing dwellings. It also explains that self-certification is voluntary and that an owner may instead arrange for a City Building Inspector to perform the verification.
Who needs it
A property owner completing the voluntary self-certification for a dwelling's required alarms and water-efficient plumbing fixtures may use this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the property owner signs and dates the verification.
How to submit this form
- 1
Download the Form
Download the Self-Certification and Verification Form.
- 2
Complete the Form
Print the property owner's name and dwelling address, review the requirements, and sign and date the verification.
- 3
Gather Attachments
The document does not list any required attachments.
- 4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Self-Certification and Verification Form verify?
- It verifies that required smoke and carbon monoxide alarms are installed and tested, and that plumbing fixtures meet the stated water-conservation requirements.
- Who completes this form?
- The property owner completes and signs it to verify alarms and plumbing fixtures in the dwelling.
- Do I need a notary for the Self-Certification and Verification Form?
- No. The property owner signs and dates the form; it does not require a notary.
- How do I submit the Self-Certification and Verification Form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Self-Certification and Verification Form doesn’t need a notary — but if you have another Rialto form that does, a commissioned online notary can help.