HomeMy WebLinkAbout20166131 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requestsr (714) 667-2738 lnspector Section: (7'14) 647-5853
Electrical Permit #: 2Ol6513{
Pin #: 72223
Project Address: 825 N Enolish St
Assessor'sParcel: 405-12'l-02 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range;
Historic: No
Suite Range:
Zoning: Rl
E
Owner:
Address
Contractor:
Address:
Phone
Tenant Name
Jose Avila
825 N English St
Santa Ana, CA 92703'1901
(714) 552-804'.1
SolarCity Corporation
1831 Ritchey St
Santa Ana, CA 92705
(702].785-2998
Fe. Typo
01116002 51600 General Plan Update
Amount
21 .25
Qty
0.00
Fee
$0.00
Phone
State Lic #: 888104
Lic Type: B, A, C-10, C-20, C45
Bus Lic #: 324401
Workers' Compensation lnsurance:
Carrier: Zurich
Policy #: WC0182018
Expires: 1013112018
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Solar
Solar
Occupancy:
Constr Type
Code:
R-3, U
VB
cEc 20't6
Date
Date
Date
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$0.00
$0.00
$0.00
sden, Julie
Buildins Permit #: 101 96719
Every pemit issuad shall becorne invalid unless the work on the site
authodzed by such perfiit is commenced within 180 days after its
issuance, or il the wo* authorized on the site by such pemit is suspended
or abandoned for a peiod of180 days after the tine the woh is
cofifienced.
061'1212014
Account#
lnspector MID#: 2018-143926
Fee Total:
Paid to Date:
Balance Oue:
Building Use:
Job Type:
Nature of Work:
Notes: lnstall(19) roof mounted solar panels. FEES PD lN
FULL ON 10196719
ELECTRICAL.INSPECTOR RECORD
DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATTON
I hcBb, s,firo lndcr pcidry or p.rrxry rh{ I m cr.nfl t ,r rh. Cotrtudor Ltcns tjw lor rhe followi.s ?.rw,n ( Se ?01 , 5
Busincss aM Profcsion Codc): Any Ciry or Colmy uhth r.quncs ! Irrmn to .on(rud. 'l!6. improv., {rcmlish or rcp,n my
(rudurc. prd to ils nsumc. sls rcquircs thc rpplk3nt for such [Ermir ro filc a ri!(d (d.mnr rhd h. or shc is liccnsd I,usuanl
r.
'hc !ftvnio.i 01lh. Conrack \ Li.cnr.d hw lchaptcr 9. Commrciry wirh Sccrion 7OO0 of Division I orrh. Butncs and
Prcfcsions Codc) or rhat tc nr shc h crcmpr ricrc{rom and rlE bosn ao, rhc llkgcd.rcrprirn Any vrihrionofScdbn T0ll5 by lny
utplicanr for aPcmit subr.crs thc trpplicanlrr,!civilpcnalryolnor )drhM nv. hundrcd doll&s (Ssm).
-l,
ns owncr of rhc potcny, or nry cmpbyccs wilh wascs as rhct $lc co'nlJ.ns,lion. will do th. work ,nd rhc stulE is nor
i ctrdcd orofiercd lo. sic (Scc.7or4. Businc$ lnd Pn,rc$n,ns C.dt: Thc Cont,.hls Ltcnsc Low docs nololply ro enowncrot
rhc pmFily wt(, builds or irororcs llEm..ond *ho des suh MrI hinsclfor hcEclror rhough hh or hr o*ncmployccs.
,rovidcd ihar snch inDbh,En*m nor int€ndcd ororlcr€d tursk.ll hrsrw. rh. hoikliq or in{,rclcm i\ v'ld wirhin onc yls
of conrplclion. lnc Oprcr Builds will haw the t urdcn of pm'ins lhd h. or shc did an bitl .i inrpmw tE ImFny tin lhc lruqnc of
-l..sosmr
ofrhc pmpcny. xnci.llsivclyc.ftscrins $irh liccnsd conrhcbf k, construcr trE Foiccl (S(. 7o1rl, Bu\ircs
dxi E frsri,n Codc: Th. Conrn ror's Li.c.s. Las d@s nor apllyro 0nowrcr ofprol,cn, sho tuilds o, improkr th.rcon.
lnd *ho conrracls lor sEh I'mjccls wnh a Conhcro{s) liccnscn llusunr ro rh. Co rnciors Lim* tis).
-l
amcxcmpt undcrSelion-. B. & PC forlhh rco$n
IIAXtrEAI.EAMIINSAIII]N
DECI/3AIII}!
I hcrchy rllnm undc, pcMlt) .l l{rJry.trc oflhc Inibanr8 dcclarari{nx,
-l
h.!c udsill nEinioitr rCcnific.rcofConscnr roSclf-lnsurcl *o,kcr' co6pctrs,ri.n. .s povidcrt lor bySection l?0o ollhe
tih,ACd.. ro, rh. ndinrnrn!. nf rhl $mt lor wh(h rhc F.rm F Fsucd
IS,&" -o *',,*,*, *",kcis (nmn(nr nn in\urarce. a\ .cquired h, s*! k n r7{D or $. bhor c'odc. ro, rhe pcrti,mmc ol
/rhc *,X.Jor whth lhn Nm trtr.Jcd Mt {orko| mnFn{rinn 'n\u,sm$nrr rd FlEynumt rec
,.,*q ql2) t<l
I
-l
ccnily lhlr in rh. pcrlornuncc olrhc *or( for which rhn pcrdir is (\rcd, I shnll not cnrplo, any pcson in rny nruncr
{, a\ k, b.dne \ubjc.r ro rhc work.r\ drrp.n\dio. hws ofCdliroxrir. rnd alrcc lhar iil shoukl i.comd sxhjcd h rhc
workds.onil.nsdionpn,vi\ionsofsc.rionlTmolrlrLrh.rOxlc.lshrll.n,nhsirhcom,,ly$irhrho{fovi{onr.
WARNINC: Failure lo ccurc work r' conFnerinn covcBsc is lnl,wrul. rd shall subrcct an .mployer lo.nmi.ul Ilcnllir\ rnd
ciril litrcs up ro onc hunded rhousnd douor (SllD,0oO). in addirnn io rh. con olctnvcnsarion. d.msc\ ar pr.viddl ror rrt
Sarion ll)'76 ofrhc Lalnr Codc. inrcrcn 3nd olromy\ accs
UCIISr:D.l()NIBrlglB
UIT:LIAAIIQN
I h.eby nrmundd pcnrlly of lErjury lhal ! am lienrt undcr Fovtion ofChspr4 9 (.om.fti.8 *irh S.clion 70(x)) ofDivision 3
of rhe BuriEs and Pmf.sions Code. rd my liccnsc is in tull Iorc and r,lecl.
ct+4r,b \q 0+
k {r4r3
CANIIAUSU!}IIIEDI!!;AGEI.CI
I hcrby.ftrn undcr Fn,lry of perjury lhal llEE h a onsldction lcndins.scrc,lor lhc t rfoln,m orrrE work for *hich lhh lErmir is
hsucd (Sa. 3097. CiY. C.).
AEUCANI.IECI.AEAIIQN
I hcrchy dtid unds pcuhy of Frjury oic of rh. r.ll.wing declrmtionx:
ocmlilion Pcrmils.Asbcslos Nolifi caliotr Fcdcrol Rcsulalions (Tilb.r0- Pln6)
-R.quircd
t rlcrof Notificalion
I .Er6 ro @nD|y wnh .I Cny ud counly
ltiEs ofrhi. Ciry mrt Counly lo €nl6 upo. tlE
-," q[\4t8
(4 pDI
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Satety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildino
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinqs (Hard & Soffit Rouoh
Ceilings (T-Bar Rough)
Rough
Service lvleler
FINAL 8 >1\19 /,LldE@
Notes, Remarks, Etc
APPROVALS
Ivleter Release
L.nd.r\ AddrE$:
-
----+---
I
Plannlng & Building Agency
Bulldlng Safety Dlvision
20 Clvic Cent€r Plaza
P.O. Box 1988 (H-'19)
Santa Ana, C492702
(714) 8476800
www.aanta-ana.org
RESIDENTIAL
PHOTOVOLTAIC
CHECKLIST
sol-01 cBc 2013
Solar Photovoltalc (PV) Checkllst for Detached SINGLE FAMILY RESIDENCES Only
lnstructlons: The licensed contractor of record shall complete all sections, answer the ten questions and
sign the certification section below. A copy of this form shall be attached to each of TWO sets of plans, of
minimum 11' x 17" size. lf answe rino NO to anv of the questions . olan check 6hall be reouired.
Projoct Address:825 English St, Santa Ana, CA 92703, US
Contractor Company 1"r". Solarcity
BBB 104Contractor License Number:
YES NOtrtr Are the followlng applicable to the proposed project?
Will the PV system layout provide the required three.foot wide clear access pathways
per Section 605.'ll of the California Fire Code, and is this shown on the roof plan?
Will the PV system be installed on a roof having only one roofing layer with no
overlays?
Will the PV array be flush mounted to the €xisting roof so that lhe plane of the
modules (panels) are parallel to lhe plane of the roof?
Will the PV system weigh maximum 4 pounds per square feet or less?
Will the PV system be installed where the modules do not overhang any roof edges
(such as eaves, gabled ends, ridges and hips)?
Will the PV system be installed with a space of 2" minimum to 10'maximum betw6en
the underside of modules and the surface of the roof?
Will the PV system be installed without using any ballast system or counter-weight
system?
Will the anchors be installed with a maximum horizontal anchor spacing of 6 feet
and is this maximum horizontal spacing shown on the plans?
Will the minimum 5/16" lag screws be installed with a minimum o12-112 inch
embedment into roof rafters (with pre{rilled holes) and is this minimum embedment
shown on the plans?
Are ALL the structural pages of the plans WET slamped and signed by a California
licensed professional engineer? (including prolect specific site plan, PV layout,
anchorage spacing, anchorage details and manufacturer's PV support information.)
2
1
9
trtr
ao
trtr
@tr
Eltr
atr
4
5
6
7
I Eltr
gtr
10 trtr
I certlfy under penalty ot periury under the laws of tho
PrintName: NlrQfrSSd IDXX s
State ol
rg
Phone Number:uz-lq 6 eAqq 961s. 5/30/2018
Email Address:
Rev: 8/17f2015
[\l fr x x tar rn i {,4,4i1) @.1Qr4a. aTm
ia that tho ls true:
-'-SANTA
NAIIiHI
The Solar America Board for Codes and Standards (Solar ABcs) Expedited Permit Pro-
cess provides a means to differentiate systems that can be permitted quickly and easily
due to their similarity with the majority of small-scale PV systems. Those systems with
unique characteristics may be handled with small additions to this Expedited Permit
Process or may require much more intormation, depending on the uniqueness of the
installation.
The following pages contain forms for the Standard String System to use with the Expe-
dited Permit Process. The Micro-lnvertet AC Module, and Supply-Side Conneclion forms
are also available as interactive PDF files at www.solarabcs.org/permitting. In jurisdic-
tions that have adopted the Expedited Permit Process lor PV Systems, these forms can
be filled out electronically and submitted in either printed form and via email. An elec-
tronic format is used so that the supplied information is standardized and legible for the
local jurisdiction.
IEfl{TTV':
2c \bb_rs_tK3-r Uv6_ACllc
rG
EXPEDITED PERMIT PROCESS FOR IV SYSTEMS
EXPEDITED PERMIT PROCESS FOR PV SYSTEMS
STANDARD STRINC SYSTEM
-rt
ni
)
I
i
I,
I
i
i
i:"
lr=
I rr-o.
llvl;cF
t
. ocHOOL OtsTRtc I
EXPEDITED PERMIT PROCESS FOR SMALL-SCALE PV SYSTEMS
STANDARD STRINC SYSTEM
The information in this guideline is intended to help local jurisdictions and contractors identify when PV system installations
are simple, needing only a basic review and when an insEllation is more complex. lt is likely that 50%-75% of all residential
systems will comply with these simple criteria. For projects that fail to meet the simple criteria, resolution steps have been
suggesled to provide as a path to permir approval.
Required Infornation for Pennit:
1. Site plan showing location oF major components on the property. This drawing need not be exactly to scale, but it
should represent relative location of components at site (see supplied example site plan). PV arrays on dwellings
with a 3'perimeter space at ridge and sides may not need separate nre service review.
2. Electrical diagram showing PV array confrguration, wiring system, overcurrent protection, invertet disconnects,
required signs, and ac connection to building (see supplied standard electrical diagram).
3 Specification sheets and installation manuals (if available) for all manufactured componenm including, but not
limited to, PV modules, inverter(s), combiner box, disconnects, and mounting system.
Step 1 : Structural Review o[ PV Array Mounting System
Is the array to be mounted on a defined, permitted rcof structure? Eyes Er,lo
Il No due to non-compliant roo.f or a ground mount, submit compLeted worksheet Jor the structure wKSl .
Roof Inforrnation:
YESl. ls the roohng type lightweighr (Yes : composition, lightweight masonry. metal. elc ..)
U No, submit completed worksheet Jor roof structure Wt(S,l (No = heavy masonry, slate, etc...)
2 Does the roof have a single roof coveringz Eyes E r,lo
IJ No, submit completed worhsheet Jor rooJ structure wKSl .
Flashing, geocell sealant
M ount ing Sy st efi InJorTn at i on :
neered product designed to mount PV modules with no more than an 18" gap
Yes E no
Il No, provide details oJ structurql attqchment certifed b)/ a design projessiond.
2. For manufadured mounring systems, 6ll out information on the mounting system below
stem Manufacturer ZS producr Name and 114o6"11Comp V4 w flashing-insert
1006
l. Is the mounting structure an en
benearh the rnodule frames?
a. Mounting Sy
b. Total Weight of PV Modules and Rails bs
c. Total Number of Attachmenl Poin
d. Weight per Attachment Point (b : c)bs (if greater than 45 lbs, see WKS I )
t.63
15.96
e Maximum Spacing Between A[tachment Points on a Rail 48 inches (see product manual For
maximum spacing allowed based on maximum design wind speed)
Total Surface Area of PV Modules (square feet)349f
g
tu'
Distributed Weight of PV Module on Roof (b - l)2.88 lbs/ftl
Il distributed weight of the Pv system is grcater than 5 lbsfP, see wKSl .
Step 2: Electrical Review o[ PV System (Calculations for Electrical Diagram)
tn order for a Pv s]Etem to be consider€d for an expedited permit process, the following must apply:
1. PV modules, utility-interacrive inverters, and combiner boxes are identihed for use in PV systems.
2. The PV array is composed of 4 series strings or less per inverter.
3. The toml inverter capacity has a continuous ac power output 13,440 Watts or less
4. The ac inrerconnec[ion point is on the load side of service disconnecting means (690.64(8)).
5. One of rhe srandard elecrrical diagrams(El.l,El.la,El.lb,orE1.lc)canbeusedtoaccuratelyrepresentthePV
system. lnteractive PDF diagrams are available at www.solarabcs.org/permitting.
Fill out the standard electical diagram compleiety. A guide to the electrical diagram is provid.ed to help the appltcant
understand each blank to ltl in. Il the electrical system is more complex than the standard electrical diagram can ellectively
communicate, provide qn alternatfue dtagram n)ith appropriate detail.
2 EXPEDITED PERMIT PROCES5 FOR PV SYSTEMS
3 Provide method and rype of weatherproofrng roof penetralions (e.9. flashing, caulk)
STANDARD STRINc SySTTII SITE PLAN
:
F
a-
do
(.)
od
i:d
c-
o
!o
Site Plan
for Small-Scale, Single-Phase PV Systems
ContrEclorNrm..
Addrca3.nd Pho..
Sile Name: 1.". a,r"
Site AddreSS: 82s EneEh sr, ssnra ans, ca e2703. us
System AC Size:6.r7kw
NT5 Date
AC4
gEB__-'l
=
l!0
One-Line Standard Electrical Diagram for
Small-Scale, Single-Phase PV Systems
Site AddreSS 82s Ens,sh sr. sanra Ana cA 92703. Us
Sile Name:Jos6Av,ra
System AC Size
NT5 Dat€
o EQUIPMENT SCHEDULE
TAG DESCRIPTION
SOLAR PV MODULE
2
J.BOX (IF USED)
5
COI\,4BINER (lF USED)
DC DISCONNECT
6 DC/AC INVERTER
GEN METER (IF USED)
* DG222NRBAC DISCONNECT (IF USED)
240 VAC, lCO A MAIN 1OO A BUS --JLA INVERTER OCPDSERVICE PANEL
PART NUIVBER NOTES
UTILITY
SERVICE
8 collenHammer 60A 240Va. Non-losible NEMA 3R
9
SEE NOTE 5 FOR INVERTER OCPDs ALSO SEE GUIDE SECTION 9)
II
BUI DING
GROUNDILLG
ELECTRODEFOR UNUSEQ SEBIES SfBING$
eULNIA'Ii! ELANK ABovE
SEE GUIOE APPEND]ISEO8
IN F ORI\4ATIOILO N MODULE AND
ABBAY GROUNDING
Disregard if
provided with
inverter
A CONDU T AND CONDUCIOR SCHEDULE
TAG DESCRIPTION OR CONDUCTOR TYPE COND NUI\,1BER OF CONDUIT CONDUIT
GAUGE CONDUCTORS TYPE SIZE
N/A
N/A
1 USE-2 tr or PV WRE El
BARE COPPER EO, GRD. COND. (EGC)
2
T
Z THWN-2 E oTXHHW-2 O or RHW-2 D
THWN-2 E or XHHW-2 tr or RHW-2 D
10 EMT
10 EMT 314"
INSULATED EGC
DC GROUNDING ELECTRODE COND
5 THWN-2 E or XHHW-2 D or RHw-2 0
10
I EI,IT 314
Ei\,lT 3/4
3
INSULATED EGC 8
r Box6
seares so
N,lODULES lN :
URC E.CIRCUIT I
COMBINER
INVERTER
AC DrSCODC D|SCO
6
se-nreS s6
MODULES IN I
unce-crncurr I
)o
MAIN
INVERTER
OCPD
O MoDULES IN .
sEnres s6unce-crncurr !
STANDARD STRING SYSTEM ELECTRICAL DIACRAM
F
d.o
Uodc-
F
2d
o
L
3
I
rl
_a_
l
3
7 voouLES tt',t
SERtES SOURCE-ClRCUlT.
TT
NOTES FOR STANDARD STRINC SYSTEM ELECTRICAL DIACRAM
Notes for One-Line Standard Electrical
Diagram for Single-Phase PV Systems
Site Address:
Systern AC Size
Site Name: .-.,
o,awn By Sean Ferneyhough
NTS Date:
SolarCity Standard
5.65
57.6
69.6
6.03
12
t\rAx voLTAGE (TYP 600Vo.)
325
NOTES FOR ALL ORAWNGS
SIGNS_SEE GUIDE SECTION 7
SIGN FOR DC DISCONNECT
PV i.4oDULE RATINGS@ STC (GUde Sceliorl)
OCPD = OVERCURRENT PROTECTION DEVICE PHOTOVOLTAIC POWER SOURCE
[,ODULE MAKE
RATED IV]PP CURRENI 5.19 A
IUODULE I\,{ODEL 786.8 v
IUAX POWER.POINT CURRENT (IMP)1040.42 v
MAX POr ,€R.POTNT VOLTAGE (VMP)I NVERTER RATI Ncslcljdqse4len 4)
OPE N-CTRCUTI VOLTAGE (Voc)INVERTER MAKE Delta
sHoRT,CrRCUrr CURRENT (rsc)INVERTER MODEL Solivia 5.2 TL
I\,,IAX SERIES FUSE (OCPD)208 v
l\ilAxll\,t U M POWER (PMA)5200 w SIGN FOR INVERTER OCPD AND
AC DISCONNECT (IF USED)24O v SOLAR PV SYSTEM
AC POINT OF CONNECTION21.6 A
IF COEFF SUPPLIED CIRCLE UNITS 35 2a
240 v
THIS PANEL FED BY MULTIPLE
SOURCES (UTILITY AND SOLAR)
NOTESfOB AABALCEqU|T WRING (Glide-lealian tund E aodlp D):NOTES FOATNVEBIERIlBCU[SlGurdqSecllatr 8 a! 9)
1 ) LOWEST EXPECT AMBIENT TEMPERATURE BASED ON ASHRAE MINIMUM MEAN
EXTREME DRY BULB TEMPERATURE FOR ASHRAE LOCATION IUOST SIMILAR TO
INSTALLATION LOCATION. LOWEST ExPECTED AMBIENT TEI$P iL"C
2 ) HIGHEST CONTINUOUS AMBIENT TEIUPERATURE EASED ON ASHRAE HIGHEST
MbNTH 2% DRy BULB TEMPERATURE FoR ASHRAE LocATroN r\,rosr s[\,ttLAR To
INSTALLATION LOCATION HIGHEST CONTINUOUS TEMPEFIATURE L"C
2 ) 2OO5 ASHRAE FUNDEI\4ENTALS 2% DESIGN TEIVPERATURES DO NOT EXCEED
47"C IN THE UNITED STATES (PALI\4 SPRINGS, CA IS 44 1"C) FORLESSTHAN9
CURRENT-CARRYING CONDUCTORS IN ROOF.MOUNTED SUNLIT CONDUITAT
LEAST 0,5" ABOVE ROOF AND USING THE OUTDOOR DESIGN TEMPERATURE OF
47OC OR LESS iALL OF UNITED STATES)
a) 12 AVVG 90"C CONDUCTORS ARE GENERALLY ACCEPTABL E FOR MODULES
WTH lsc OF 7 68 AlvlPS OR LESS \.,ltiEN PROTECTEo BY A 12 A[rP OR SMALLER
FUSE,
b) 1O A\T6 gOOC CONDUCTORSARE CENERALLY ACCEPTABLE FOR MODULES
WTH lsc OF 9 6 AMPS OR LESS wl-lEN PROTECTED BY A 15-Al\,1P OR SIVIALLER
FUSE
1)
R
IF UTILITY REOUIRES A VISIBLE.BREAK SWTCH DOES THIS SWTCH MEET THE
EQUIREI\,1ENT? YES E NOD N/AB
2) IF GENERATION METER REQUIRED. DOES THIS I'ETER SOCKET IVEET THE
REQUIREMENT? YES O NO tr N/A I
3) S|ZE pHOTOVOLTATC POWER SOURCE (DC)CON0UCTORS BASED ON rrAX
CURRENT ON NEC 690.53 SIGN OR OCPD RATING AT DISCONNECT
4) SIZE INVERTER OUTPUT CIRCUIT (AC) CONDUCTORS ACCORDING TO INVERTER
OCPD AMPERE RATING. (See Guide Section 9)
5) TOTAL OF . INVERTER OCPD(S) ONE FOR EACH INVERTER OOES TOTAL
supply BREAREFS coMpLy wrH 120dl, BUSBAR ExcEproN rN 690 64(B)(2){a)?
YES E NOO
I\,,IAX CIRCUIT CURRENT
RATFD MPP VOLTAGE
IIIAX SYSTEI\4 VOLTAGE
i.4AX DC VOLT RATING
r/Ax PowER @ 4o"c
i.4AX OCPD RATING AC OUTPUT CURRENT
NOMINAL AC VOLTAGE
I
c-
do
Uod1
F
d
c-
o
Lo
X
NATIONAL ELECTRICAL CODE@ REFERENCES
SHOWN AS (NEC )aX X^)sc sc325
5.59 A
WARNING: ELECTRICAL SHOCK
HAZARD_LINE AND LOAD MAY BE
ENERGIZED IN OPEN POSITION
I
looo vl NOMINAL AC VOLTAGE
[ ,* ^. .r--*"voc TEMP coEFF (mv/"Ctr or %ioctr) -0.262
l
*-SANTA
NA'Iffi
Planning & Building Agency
25 Civic Center Plaza Rcss Ainex Smoke & CO
Alarm AffidavitP.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-5800
r/Y/r,/.santa-ana.crq
t\sP-c2 2c13 iR:
fhis document mdy be found ot.-.
(Please use a black or blue ink ball-point pen)
Project Address:ist"
I Permit Number:
Property Owner:
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
buildings.
California Residential Code (CRC) Section R314.1and R315.2 states in part that eiisting dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define
the required locations.
Both boxes below must be checked:
Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
edrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
ap ances (i.e. hot water heater, cooktop, furnace) or a fireplace.
Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping
m, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no interior alterations are
performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved
by the State Fire Marshall (SFM). Ba life must be 10 vears
I hereby certify that I
that smoke alarms an
Codes and have been
man ufacturer's instru
am the c ract or the property owner of the above project. I further certify
dca mon de alarms have been installed in compliance with the governing
s dtob nctional. l, also, hereby certify that I will retest the alarms per the
ns.
lcheck onel Licensed Contractor Property Owner
Contractor:-i'*.ta-License #:ff{tr/
Signoture: I ,Y-/Dote
i
Have this completed form and the job-card readily available on final inspection!
?l>r L{ot4t
tr
NoTE: Ihis sef-certificdtion is only used fot projects thot dffect the EXTERIoR of the strudure. This
process is applicdble ONLY to projects where access to the interior ol the dwelling by o Santd Ano
lnspector is not required.
lv