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tNSP-02 2013 CRC <br />This document mdy be lound ot...http://www.santa-ana.o rolohal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:'z)29 f,. cc$+ <br />Permit Number:)ctto\571 <br />Property Owner:& I,l;stl r^,tr;\ <br />Contractor:CULIiFIE\ lzs'vt,t6 License *, 75b'?11 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 R314.3 and R314.3.3 define <br />the req u ired locations. <br />fl aott boxes below must be checked: <br />(Crrbon 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 />applances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Hsmoke "larms: <br />Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />ioom, 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 I will retest the alarms per the <br />manufacturer's instructions. <br />Licensed Contractor Property Owner <br />NOTE: Ihis sef-certificotion is only used lor projects that affect the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by o Sontd Ano <br />lnspectot is not rcquired. <br />Have this completed form and the job-card readily available on final inspection! <br />Signdture:-'7'/rr- / t,t*rn\Ddte 1- ra -? c,)c <br />,'-SANTA <br />NA <br />PLt$[C <br />& 8t ltlt\c <br />lct\0 <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box'1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.s800 <br />www.santa€na.oro <br />Smoke & CO <br />Alarm Affidavit <br />I <br />I <br />I <br />l <br />I <br />(check onel