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COPY
15150 V entirra 8t.,c Sr;ite D t0l
E;rcino, CA 91116
Phone: (8t8i 19+-9122
Enaii: inf c@arurnwcrks. com
wraw o lurn'erod<s . corn
w)fl
November+tn ,7.02A
To Whom lt May Concern:
Re: New Perrnit
l, Eyal Elrom, owner and president of Alum Works lnc License fi 857189 authorize Ralph James
to pull permits from the city and county Building & Planning Departments on my behalf.
Tha n ks,
Eyal EIrom
a
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857189 l,JR P
AUUM WORKS INC
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CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE g 8202
f.
ij See Attached Document (Notary tc cross out lines 1-6 below)
tr See Statement Belour (Lines 1-6 to be completed only by document signer[s], not Notary)
Signoture of DocLrment Signer No I Signature of Document Signer No. 2 (if ony)
A notary public or other officer completing this certificate verifies only the identity of the individualwho signed the document
to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of Ca iiforn ia Subscribed and sworn to (or affirmed) before me
\.)t '(': ,' 'l-'! i' ,1 /'A'
on this ' day of
by Dote
! r ,'_ r'l !.
,
Month
2 Ir-
Cou nty of
Yeor
(1)V ,\',\ | elfi'i i^r'" a-'4'r- -"r
(and (2)),
YVETTE LEE
Notary Public - Californja
Los Angeles Ccunty
Comrnission # 221ffi97
tuly Comnr. Expires Cct 2, 2O2l
Nome(gfI of /
Signer$)
proved to me on
be the persoy's)
of sati sfactory evidence to
a d before
Signature
Ploce Notory Seo/ ond/or Stomp Above of No
OPTIONAL
Completing this informotion con deter olterotion of the document or
froudulent reottochment of this form to sn unintended document.
Description of Attached Document
Title or Type of Document:f i,u'r,vTr \rr ,, ', 1., ) lt \ h AAY I k
il v (
Docu ment Date.Number of Pages:
Signer(s) Other Than Named Above
, 2017 National Notary Association
)\
-/ \-/'-
I
?(tA
CITI"SANM
NAfinH'ill
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-19)
Santa Ana, CA92702
(7141647-5800
www.santa-ana.oro
Smoke & CO
Alarm Affidavit
rNsP-02 2013
This document may be found ot... http://www.santa-ana.orq/pba/
(Please use a black or blue ink ball-point pen)
Project Address:37oq S. Alolrn S+.
Permit Number:tot lo6bc/Ll
Property Owner:
Contractor:License #:
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 existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define
the required locations.
n Both boxes below must be checked:
Ef Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
M Smote alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping
room, 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). Battery life must be 10 years.
I hereby certify that I am the contractor or the property owner of the above project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the
manufacturer's instru o ns.
(check onel Licensed Contractor Owner
NOTE: This self-certification is only used for projeds that affed the EXTERIOR of the strudure. This
process is applicable ONLY to projects where occess to the interior of the dwelling by o Sonto Ana
lnspector is not required.
E/
Signature:(Dote:1t
Have this completed form and the job-card readily available on final inspection!