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*-SNTA <br />NA.Tffi <br />Plan ning & Building Agency Smoke & <br />Alarm Affi <br />CO20 Civic Center Plaza Ross Anner <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(7r4) 647.s800 <br />w,J!^/v.sant3-ana.orq <br />davit <br />lNSP-02 20r3 CRC <br />fhis document mdy be found ot...h ttp:1i,,,./v,,v. sa n ta -a na.or q, Pba, <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:U (- <br />Permit N umber: <br />Property Owner:L <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildin gs. <br />California Residential Code (CRC) Section R314.1and R315.2 states in pa,t that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />f\ goth boxes below must be checked: <br />[CrrUon 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 />6gpliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />flSmofe alarms: Are instalted in each roorn used for sleeprng, 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. Combinatjon Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall {5FM). 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 />manuf acturer's instructions <br />Signature:Tt <br />lcheck one)tr s d Con tractor Property Owner <br />NOTE: Ihls sef.c lrtification is only used lor projects thdt dffect the EXTERIOR ol the snucture. This <br />prccess is applicable ONLY to projects where occess to the inteior ol the dwelling by d Sontd Ano <br />lnspector is not rcquircd. <br />rl Dot e: <br />\g <br />Have this completed form and the job-card readily available on final inspection! <br />1 <br />I <br />t <br />lDtq<q7_7 <br />/n A