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*JNTA <br />,{}l{,-#i <br />2a C:r':.:',> a:.r loss A,-.e )a S;rroke & CO <br />Alarrn Affiia','ii?.O. 3or 1988 {,r-19) <br />SanS Aia. CA 92702 <br />(714) 6a7.5aCC <br />Parml: li,rmJ€i: <br />T:1is dcc; ,:^ani fio',r be lound a:... <br />(.oiers.e Nse a bla.ck or blue ink ball-poini p'en) <br />2o 1 <br />P,'o,r,e;y Ornar: <br />n ^ ^.'. ^. .! .. <br />B,. \I :(d <br />ilov iz !.[.-Licansa *: ( c15, .,G? V zf 3 <br />State of California requires that smok3 and carbon monoxide (CO) alarms ai'e installed in residential <br />b u ild ing s. <br />California Residential Code (CRC) Section R]14.1 and R315.2 states in part that existing dwellin8s be <br />"retrolitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R315.3 define <br />the required locations. <br />f,\ *,:,, boxes belo.* must be checi:d: <br />4 kr"." riroiro;(;d€ alarms: Are inst3lled outside of each sleeping a.ea in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are recommended in bedrooms with gas-flreC <br />appliances (i.e. hot water heatsr, cooktop, furnace) or a fireplace. <br />-1L-YSno'<e ala:ms: Are insta'led in e:ch roorn used for sleeping, in e:ch hallway outside of a sleeping7- <br />room, and on e ach levelof 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). 8attery 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. <br />lcn e:k anel PLice nsed Con tractor ro9erty ner <br />NOT:: nir i3Jl-cel.ifu?/tion it oolit us-ed lor Noj.zcts that aij.ct dt.t LXIER|'OA oi the s'iuawt. fhis <br />2roctss is o2.clicotle O,tl!.'l tc ptoj.?ds where qcc.ess tc th.e inleri ol lh. dwrfiiag by o lr,nia Ano <br />lnsp ? cic' ii nol trq uir rd. <br />IIIZL IfiZ'- l-^Dst?: <br />Have ttr'is com!leiad form and the job-card reaCily availarla on final ins.!ect:cn1 <br />jJio.3ci;!cr3ss: <br />I qa1 I <br />2 /. ,,- <br />'l1t ^s,' <br />Signolure: <br />I