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,'O Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Al arm Affi davitP.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(7 14) 647-580 0 <br />,l|lr'lt s a n t a-a n a. o'-!l <br />INSP-02 2013 CRC <br />This document may be found at,.,htt O'. f '',t;,',..r./. Sa n t e -an a . O retoca <br />(Please us e a black or blue ink ball-point pen) <br />Permit Nurnber:o LIZ <br />I Property Owner:Xoc +( <br />Contractor:iilrfiiekrte,^/ 3€O License #:7sz3rl3 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California ResidentialCode (CRC)Section R314.L and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRCSection R314,3 and R314.3.3 define <br />the required locations. <br />fl\ Both boxes betow must be checked: <br />(C.rUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each levelof the dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />fls.ot. 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 (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 />m a n ufactu rer's instructions. <br />(check onel Licensed Contracto r Property Owner <br />NOTE: This self-certificotion is only used for projects that affect the EXTERTOR of the structure. This <br />process is applicable ONLY to projects where occess to the interior ol the dwelting by o Sdnta Ana <br />lnspector is not required. <br />Project Address:3toS S. Poc){. }rre, S*/Jqenq. cg.?2fu) <br />Signature -4 Date 7/ ?/ ,r <br />Have this completed form and the job-card readily available on final inspection! <br />flII <br />.ruMIIfi <br />til[m0 <br />TGTtrI