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INSP-02 2013 CRC <br />This document moy be lound at..http;//www. sa nt a-ana.orelpbal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2l9l -1, Cet'qu rt <br />lonauo <br />Property Owner:hlft**N ptcy! GVIP Lt c <br />Contractor:ZtLo Pteh-oY to, ] Li""n'" *: f 5341) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <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 R31.4.3 and R314.3.3 define <br />the required locations. <br />Aro,n boxes below must be checked: <br />ECarbon 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 />\-/lil Smoke 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 lwill retest the alarms per the <br />ma n ufacturer's instructions. <br />lcheck Licensed Contractor Property Owner <br />NOTE: Ih,s se,f-certificotion is only used Iot projects thot dlfect the EXTERIOR of the structute. This <br />process is opplicoble ONLY to projects wherc occess to the interior of the dwelling by o Sonto Ana <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Signotute:Dote:6-zo-17 <br />T,,O,SNTA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 'l988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />I <br />I <br />I <br />Permit Number: <br />I <br />I <br />tr