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ilSNTA <br />NA,'ffi <br />Planning & Building Agency <br />20 Civic Cente r Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />WWrv.Santa-ana. oro <br />This document mdy be found at...san <br />(Please use a black or blue ink ball-point pen) <br />state of california requires that smoke and carbon monoxide (co) <br />buildings. <br />california Residentialcode (cRC) section R314.1 and R315.2 states in <br />"retrofitted with smoke alarms and carbon monoxide alarms. cRC <br />the required locations. <br />ABoth boxes betow must be checked: <br />fi.caruon monoxide alarms: Are installed outside of each sleeping a <br />bedrooms and also on each level of the dwelling. Alarms are required <br />2013 CRC <br />are installed in residential <br />rt that existing dwellings be <br />,n R31.4.3 and R314.3.3 define <br />a in the immediate vicinity of <br />bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />f,smore alarms: Are installed in each room used for sleeping, in e <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where <br />hallway outside of a sleeping <br />or alterations are <br />performed. combination smoke/co alarms must comply with all appl <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 <br />ble standards and be approved <br />bove project. I further certify <br />that srnoke alarms and carbon monoxide alarms have been installed compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify th I will retest the alarms per the <br />man ufacturer's instructions <br />lcheck onel F Licensed tr Owner <br />NorE: This self-certification is only used for projects that affect the of the structure. This <br />process is applicable oNLY to projects where occess to the interior of <br />lnspector is not required. <br />dwelling by o Santa Ana <br />P <br />AI <br />oke & CO <br />rm Affidavit <br />Project Address:fu)D,seroP .;7a(B ,J-#r <br />Permit Number:10/ / b,7 /s/ <br />Property Owner:LftU <br />Contractor:T6(4 RoortAh License I t: /o(€6sa <br />Signoture:oatl:4u /,a <br />Have this completed form and the job-card readily availab on final inspection! <br />+