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tNSP{2 2013 CRC <br />Ihts do(itment moy bc lound at- httDJrlwvw.santa-ana.oro/Dba/ <br />(Please use a bleck or blua lnk ball-polnt pan) <br />ProJect Address: <br />Permit Number:I ------r---- <br />Proporty Owner: <br />contractor: Q6pg.5i,or.k u %g r.zS & Us.License #: ffiqg <br />State of Califomia requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residentlal Code (CRC) Section R314.1 and R315.2 states in part that existint 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 />Aror, oor"s below must be checked: <br />lforbon ,onodde 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 />appliances (i.e. hot water heater, cooktop, fumace) or a fireplace. <br />(Smoke 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 aherations are <br />performed. Combinatlon Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall (SFM). Eattery 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 goveming <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 tr Licensed Contractor P rope rty Owner <br />NorEz Thls self-cetlflcotlon ls only used lot ptolects thot ofiect the EXTERIoR ol the strucfine, Thls <br />process ls appllcoble 0NLY to Nqec6 when occess to the lntedot ol the dwelltng by a tunto Ano <br />lnspedor ls not rcqulred, <br />Have thas completed form and the job-card readily avallable on final lnspectionl <br />Slgnotwe:,/.-r=Dote <br />*-SANTA <br />NA <br />it$]t\c <br />N8[IIDIIC <br />lfiIo <br />Planning & Building Agency <br />20 Clvlc Ccnter Phzr Ro!! Annox <br />P.O. Bor 1988 ( -19)g.nt An., CA 92702 <br />(7la) 6a7580O <br />!0u&s[h3!tl9lc <br />Smoke & CO <br />Alarm Affidavit <br />LbbD-k %arltv<rq arrr,. NXrq_lzrol- <br />I <br />frZa-/o C?rn//rt