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Project Address:o SA\P 5 <br />Permit Number: <br />Property Owner: <br />Contractor:6 License#: /A466 <br />INSP-02 2013 CRC <br />This document mdy be found dt... http://rlrnrwv.santa-ana.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO)alarms are installed in residential <br />bu ildings. <br />California ResidentialCode (CRC)Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R31,4.3.3 define <br />the required locations. <br />nBoth boxes betow must be checked: <br />flCarbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each levelof the dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />[lsmote alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall (SFM). Battery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. I further certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />man ufactu rer's instructions. <br />Signature:.-/ ---/-/e.--Dote /,-/* <br />'^^-+,,.1(check onel Licensed Contractor P ner <br />NOTE: This self-certification is only used for projects that affect the EXTERIOR of the structure. This <br />process is applicable ONLY to projects where occess to the interior of the dwelling by a Sdnta Ano <br />lnspector is not required. <br />Have this completed form and the job-card readaly available on final inspection! <br />*-SNTA <br />NA'ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />ww.,v.santa-an a. orq <br />Smoke & CO <br />Alarm Affidavit <br />lDlro 3 ) VO <br />L4U <br />tr