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tNSP,02 2013 CRC <br />This document moy be lound ot...htlpllwww.sa nta-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:1Oq Benui qr <br />Permit Number:S*n'frf LNA e# q2103 <br />I <br />J-Jalc N,a ' \//44 -ftto <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 requ ired locations. <br />f\ so,t boxes below must be checked: <br />E[Carbon 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 />applignces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />ds.ofe alarms: Are installed in each room used for sleeping, 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. Combination 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. 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 />manufacture/s instructions. <br />lcheck onel Lice nsed Contractor <br />NOTE: Ihrs sef-certificdtion is only used for projects thot offect the EXTERIOR ol the structure. This <br />prccess is opplicoble ONLY to projeds where access to the interior oI the dwelling by a Sonto Ana <br />lnspector is not required, <br />Have this completed form and the job-card readily available on final inspection! <br />Signoture:Date:tolclt+- <br />,-,SANTA <br />NA <br />PLI\\NC <br />INIIUI|IC <br />$nn <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA92702 <br />(714) 6il7-5800 <br />www.santa-ana,orq <br />Smoke & CO <br />Alarm Affidavit <br />I <br />I eroperty owner: <br />I <br />I <br />I <br />tr d Property owner,%/?lr-