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*;SNTA <br />NA,"ffi <br />Planning & Building Agency <br />20 Civic Center Ptaza Rogs ,qnnex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />ww,v.santa-ana_ oro <br />This document mdy be found ot.., <br />201 3 CRC <br />SA <br />(Please use a black or blue ink batt-point pen) <br />state of california requires that smoke and carbon monoxide (co) al <br />buildings. <br />ms are installed in residential <br />california Residentialcode (cRC) section R314.1and R31.5.2 states in that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. cRC se <br />the required locations. <br />f\eo,h boxes betow must be checked: <br />ion R314.3 and R314.3.3 define <br />(caruon monoxide alarms: Are instailed outside of each sleeping a <br />bedrooms and also on each level of the dwelling. Alarms are required <br />appliances (i.e, hot water heater, cooktop, furnace) or a fireplace. <br />in the immediate vicinity of <br />n bedrooms with gas-fired <br />psmot e alarms: Are installed in each room used for sleeping, in hallway outside of a sleeping <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where interior alterations are <br />performed. combination smoke/co alarms must comply with all appli <br />by the State Fire Marshall (SFM). Battery life must be 10 years. <br />ble standards and be approved <br />I hereby certify that I am the contractor or the property owner of the bove project. I further certify <br />that smoke alarms and carbon monoxide alarms have been installed i compliance with the governing <br />codes and have been tested to be functional. l, also, hereby certify I will retest the alarms per the <br />ma nufactu rer's instructions <br />lcheck onel et Licensed Contractor P ner <br />NorE: This self'certification is only used for projects that affea the of the structure. This <br />process is applicable oNLY to projects where dccess to the interior of <br />lnspector is not required. <br />dwelling by o Santa Ana <br />AI <br />oke & CO <br />rm Affidavit <br />Project Address:7rB s Toc*D@a gr <br />Permit Number:- ,-1713/ <br />Property Owner:t-+c/ <br />Gontractor:1- t F6a2t't6z License I t: /ct (66-e/ <br />Signature:ootl:2O -o <br />Have this completed form and the job-card readily ava on final inspection! <br />tr