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rNSP-02 2013 CRC <br />fhis document mdy be found dt.h tto : //Wwtr'/-sa tta -ana o r,q/pbd <br />(Please use a black or blue ink ball-point pen) <br />Project Address:3 L o f, {,^ ra., $f7.;f J;-fa /D*1-ts o{ <br />Permit Number:(oll o(of-L <br />Property Owner:Koslf.- kb -o i u,, o <br />Contractor:Got L*Cour,"7 License #:r-rter/ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (CRC) Section R314.1. and 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 />A sott 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 />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />El 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 alteratlons 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 pro,lect. 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 />(check onel tr Lice n se ontractor tr Property Owner <br />NOTE: Ilris sef-certificotion is only used for projeds thot allect the EXTERIOR of the structure. This <br />process is opplicoble ONLY to projects where access to the interior of the dwelling by o Sonto Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />ne;b- qa-,---//'t\-, <br />Signdture:l-:-l -2,s.1Dote <br />*,SANTA <br />NA.ffi <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) 647.5800 <br />w,Mr.santa-an a.orq <br />Smoke & CO <br />AIarm Affidavit <br />I <br />I <br />I <br />I