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Self-Inspection Packet

  1. 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.
  2. Full Name of Individual Completing the Self-Inspection Form.
  3. Title of Individual Completing the Self-Inspection Form.
  4. Business Phone Number.
  5. Business Contact Email.
  6. Full Name of Property Owner.
  7. Property Owner Email.
  8. (Example: Apartment, Restaurant, Gas Station, Repair Garage, etc.)
  9. 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.
  10. 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.
  11. Fire Sprinkler System on Property*
    Does the property have a fire sprinkler system? If YES, upload the annual fire sprinkler report.
  12. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  13. Fire Sprinkler System on Property *
    Does the property have a fire sprinkler system? If YES, upload the 5 year fire sprinkler report.
  14. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  15. Fire Alarm System on Property *
    Does the property have a fire sprinkler system? If YES, upload the annual fire alarm report.
  16. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  17. Kitchen Hood System on Property*
    Does the property have a kitchen hood suppression system? If YES, upload the semi- annual report.
  18. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  19. Private Fire Hydrant on Property*
    Does the property have a private fire hydrant? If YES, upload the annual fire hydrant report.
  20. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  21. Private Fire Hydrant on Property*
    Does the property have a private fire hydrant? If YES, upload the 5 year fire hydrant report.
  22. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  23. Fire Pump on Property *
    Does the property have a fire pump? If YES, upload the annual fire pump report.
  24. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  25. ERRC System on Property *
    Does the property have a emergency radio responder coverage system? If YES, upload the annual ERRC annual report.
  26. It is the responsibility of the licensed contractor to provide the property owner with the most current report.
  27. 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.
  28. Leave This Blank:

  29. This field is not part of the form submission.