Yreka, CA · Siskiyou County
Smoke Detector and Carbon Monoxide Form
Property owners use this self-certification form to report smoke and carbon monoxide detectors installed at a property covered by a building permit.
What this form is
This form lets a property owner certify that required smoke detectors and carbon monoxide detectors have been installed according to the stated code provisions and manufacturers’ instructions. The city says to return it to the building inspector before final sign-off for permits requiring compliance. It asks for the property address, building permit number, detector counts, owner details, date, and signature.
Who needs it
Property owners with permits requiring detector compliance must complete the certification before final sign-off.
How to submit it
Return the completed certification to the City of Yreka building inspector before final sign-off of permits requiring compliance.
About notarization
This form is signed without a notary; the owner signs and dates the declaration under penalty of perjury, and no notarized attachment is identified.
How to submit this form
- 1
Download The Form
Download the Smoke Detector and Carbon Monoxide Form.
- 2
Complete The Form
Enter the property address, building permit number, detector counts, owner name, and date; the owner signs the certification.
- 3
Gather Attachments
The form does not identify any attachments to gather.
- 4
Submit To The Building Inspector
Return the certification to the City of Yreka building inspector before final sign-off of permits requiring compliance.
Frequently asked questions
- What does the Smoke Detector and Carbon Monoxide Form certify?
- The property owner certifies that smoke detectors and carbon monoxide detectors have been installed according to the stated requirements and manufacturers’ instructions.
- Who completes this detector certification?
- The owner of the property completes the form, providing the property address, building permit number, detector counts, printed name, signature, and date.
- How do I submit the Smoke Detector and Carbon Monoxide Form?
- Return the completed certification to the City of Yreka building inspector before final sign-off of permits requiring compliance.
- Do I need a notary for the Smoke Detector and Carbon Monoxide Form?
- No. The owner signs and dates the declaration under penalty of perjury; the form does not identify a notarized attachment.
Need something notarized?
This Smoke Detector and Carbon Monoxide Form doesn’t need a notary — but if you have another Yreka form that does, a commissioned online notary can help.