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2. Notice:
   To avoid any delays, you must submit a completed self-inspection packet and all required reports that pertain to the property. Be advised that this list reflects the minimum requirements and additional information may be needed depending on the property. The time it takes to review and process may vary depending on the complexity of the submittal.
4. Name *
   Full Name of Individual Completing the Self-Inspection Form.
5. Title *
   Title of Individual Completing the Self-Inspection Form.
7. Phone Number *
   Business Phone Number.
8. Email *
   Business Contact Email.
10. Business Address*
11. Zip Code *
13. Property Owner Name *
    Full Name of Property Owner.
14. Property Owner Email *
    Property Owner Email.
15. Business Type *
    (Example: Apartment, Restaurant, Gas Station, Repair Garage, etc.)
17. Self-Inspection Information
    CLICK HERE for Information About the Self-Inspection Process and Frequently Asked Questions.
19. Self-Inspection Form (FILLABLE)
    CLICK HERE for the Fillable Self-Inspection Form.
21. Upload Self-Inspection Form *
    Form shall be completed by the individual who conducted the inspection. Upon completion of the self-inspection upload a PDF file by using the browse button.
23. Notice:
    Please only attach the service reports related to the systems that are present on the property. As courtesy the required NFPA and State Fire Marshal Inspection, Testing and Maintenance documents are being provided to you. These documents have been included so that you are aware of exactly what the qualified technician is required to complete and provide to you as the business owner or representative.
25. Fire Sprinkler System on Property*

    Does the property have a fire sprinkler system? If YES, upload the annual fire sprinkler report.

    1. YES
    2. NO
26. Upload Annual Fire Sprinkler Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
27. NFPA & State Fire Marshal Required Report
    CLICK HERE
29. Fire Sprinkler System on Property *

    1. YES
    2. NO

    Does the property have a fire sprinkler system? If YES, upload the 5 year fire sprinkler report.
30. Upload 5 Year Fire Sprinkler Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
31. NFPA & State Fire Marshal Required Report
    CLICK HERE
33. Fire Alarm System on Property *

    1. YES
    2. NO

    Does the property have a fire sprinkler system? If YES, upload the annual fire alarm report.
34. Upload Annual Fire Alarm Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
35. NFPA & State Fire Marshal Required Report
    CLICK HERE
37. Kitchen Hood System on Property*

    1. YES
    2. NO

    Does the property have a kitchen hood suppression system? If YES, upload the semi- annual report.
38. Upload Semi-Annual Kitchen Hood System Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
39. NFPA & State Fire Marshal Required Report
    CLICK HERE
41. Private Fire Hydrant on Property*

    1. YES
    2. NO

    Does the property have a private fire hydrant? If YES, upload the annual fire hydrant report.
42. Upload Annual Fire Hydrant Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
43. NFPA & State Fire Marshal Required Report
    CLICK HERE
45. Private Fire Hydrant on Property*

    1. YES
    2. NO

    Does the property have a private fire hydrant? If YES, upload the 5 year fire hydrant report.
46. Upload 5 Year Fire Hydrant Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
47. NFPA & State Fire Marshal Required Report
    CLICK HERE
49. Fire Pump on Property *

    1. YES
    2. NO

    Does the property have a fire pump? If YES, upload the annual fire pump report.
50. Upload Annual Fire Pump Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
51. NFPA & State Fire Marshal Required Report
    CLICK HERE (Diesel)
53. ERRC System on Property *

    1. YES
    2. NO

    Does the property have a emergency radio responder coverage system? If YES, upload the annual ERRC annual report.
54. Upload Annual ERRC Report
    It is the responsibility of the licensed contractor to provide the property owner with the most current report.
56. Electronic Signature Agreement*

    I understand and agree that (i) electronically signing and submitting any document(s) to the City of Napa legally binds me in the same manner as if I had signed in a non-electronic or non-digital form, and (ii) the electronically stored copy of my signature, any written instruction or authorization and any other document provided to me by the City of Napa, is considered to be the true, accurate and legally enforceable record in any proceeding to the same extent as if such documents were originally generated and maintained in printed form. I agree not to contest the admissibility or enforceability of the City of Napa electronically stored copy of any other documents. By using the system to electronically sign and submit any document, I agree to the terms and conditions of this Electronic/Digital Signature Disclosure.

    1. I agree.
58. Electronic Signature*
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field