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t <br />C*O'SNTA <br />NAJ,ffi <br />Planning & Building AgencY <br />20 Clvlc Center Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />wwlrv.santa-ana. orq <br />3 CRC <br />This document may be found at...nta <br />(Please use a black or blue ink ball'point pen) <br />state of California requires that smoke and carbon monoxide (co) al rms are installed in residential <br />buildings. <br />California Residential Code <br />"retrofitted with smoke ala <br />the required locations, <br />(CRC) Section R3L4.1and R315'2 states i part that existing dwellings be <br />rms and carbon monoxide alarms. CRC n R314.3 and R314.3.3 define <br />ABoth boxes below must be checked <br />Elcarbon monoxide alarms: Are installed outside of each sleeping rea in the immediate vicinitY of <br />bedrooms and also on each level of the dwelling. Alarms are requi <br />appliances (i,e. hot water heater, cooktop, furnace) or a fireplace. <br />fl Smot e alarms: Are installed in each room used for sleeping, in <br />{oom, and on each level of the dwelling. <br />in bedrooms with gas-fired <br />hallway outside of a sleePing <br />Retrofitted detectors may be battery-operated for buildings where interior alterations are <br />performed. Combination Smoke/CO alarms must comply with all ap <br />by the State Fire Marshall (SFM). Battery life must be 10 years. <br />icable standards and be aPProved <br />I hereby certify that I am the contractor or the property owner of <br />that smoke alarms and carbon monoxide alarms have been install ed <br />above project, lfurther certify <br />n compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify <br />manufactu rer's instructions. <br />I will retest the alarms Per the <br />(check onel F Licensed P ner <br />NOTE: This self-certification is only used for proieas that affect the of the structure. This <br />process is applicable ONLY to proiects where dccess to the interior <br />lnspector is not required. <br />the dwelling by a Santo Ana <br />oke & CO <br />rm Affidavit <br />S <br />AI <br />ft-f7/O 5 froilsh)D SrProject Address: <br />/o//o313OPermit Number: <br />/-o ilProperty Owner: <br />License #: /o{66LTE4h Eoo,a{hContractor: <br />4Signature <br />Have this completed form and the job-card readily avai on final inspection!