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*,$NTA <br />NA,W <br />Planning & Building Agency <br />2A Clvic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />ww/v. santa-ana. oro <br />This document may be found at... <br />INSP{2 <br />(Please use a black or blue ink ball-point pen) <br />state of california requires that smoke and carbon monoxide (co) al <br />buildings. <br />california Residentiat code (cRC) section R314.i. and R315.2 states in that existing dwellings be"retrofitted with smoke alarms and carbon monoxide alarms. cRC se <br />the required locations. <br />ion R314.3 and R314.3.3 define <br />'ms are installed in residential <br />n bedrooms with gas-fired <br />ABoth boxes betow must be checked: <br />S'caruon monoxide alarms: Are installed outside of each sleeping a <br />bedrooms and also on each level of the dweiling. Alarms are required <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />in the immediate vicinity of <br />p Smof.e alarms: Are installed in each room used for sleeping, in <br />room, and on each level of the dwelling. <br />hallway outside of a sleeping <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. combination smoke/co alarms must comply with alt appl <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 <br />that smoke alarms and carbon monoxide alarms have been installed i <br />project. I further certify <br />compliance with the governing <br />codes and have been tested to be functional. l, also, hereby certify <br />man ufactu rer's instructions. <br />I will retest the alarms per the <br />lcheck onel Li cense d tr P er <br />NorE: This self-certification is only used for projects that offect the of the structure. This <br />process is applicable oNLY to projects where dccess to the interior ol <br />lnspector is not required. <br />dwelling by a Santa Ana <br />AI <br />oke & CO <br />rm Affidavit <br />Project Address:z0s fu\Y -%rt2 <br />Permit Number:/o' ^3 /s 1 <br />Property Owner:LbA <br />Contractor:7a4 ,?4oftAh License I l: .'4:669 <br />Signature:Z.-,1 z4-oatl:9u,/p <br />Have this completed form and the job-card readily on final inspection!