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lNsP,02 2013 CRC <br />Ihis document moy be lound ot...http://www santa-ana.or o Dba <br />(Please use a black or blue ink ball-point pen) <br />Project Address:LGl T 5 f*,r,i.d -9 <br />Permit Number:IO q <br />Property Owner:G^\J-,J.* l4>p <br />Contractor:Ca^+,/.,- L C-0.I <br />qq?t6-1 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (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 R314.3.3 define <br />the requ ired locations. <br />f\ aoti, boxes below must be checked: <br />-.1$[CarUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />fkmoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall (SFM). Battery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. lfurther certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instructions <br />(check onel Licen sed Contractor Property Owner <br />NOTE: Ihis sef-certificotion is only used for projects thot offect the EXTERTOR of the structure. This <br />prccess is opplicoble ONLY to projects where occessto the inteiot of the dwelling by o Santd And <br />lnspedor is not reguired. <br />Have this completed form and the job-card readily available on final inspection! <br />Signoture:Dote f- /-Ao/7 <br />,N,,'SANTA <br />ANA$[rf <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-'19) <br />Santa Ana, CA 92702 <br />(714) 6,17-5800 <br />www santa-ana orq <br />Smoke & CO <br />AIarm Affidavit <br />License #: <br />tr