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218 S. FLORETT STU 1VISION CITY OF ANAHEIM 2016 CALIFORNIACODES BUILDING DEPARTMENT CODE CYCLE C 200 S. Anaheim Blvd., Suite 145 01/01/2017 Anaheim, CA 92805 UFECTNEDArE 714 765-5153 www.anaheim.net/building SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION * Final inspection aooroval will require this completed form to be on site along with the job card. Permit Number: iS 02 My b 61 Date: Z 21 Z Project address: Property Owner: L- LNG]gl-inn The undersigned does hereby certify that I am the property owner of the property. I further certify that smoke alarms and carbon monoxide alarms functional in all the following locations. All boxes must be checked below zg6� above reterenceo are present and Smoke Alarms and Carbon Monoxide Alarm: On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms. Smoke Alarms: In each room used for sleeping purposes. �1 Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement; (Note: in dwellings or dwelling units with split levels and without an intervening door between the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level shall suffice for the adjacent lower level provided that the lower level is less than one full story below the upper level.) All dwelling units witVattache'q garages require carbon monoxide detectors. Signature: 2 California Residential Code (CRC) Section R314.6.2,CRC R315.2 states in part that existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors when a building permit is issued for work on or in a building that is valued at $1,000 or more." CRC Section R314.3, CRC R315.2 defines required locations as indicted above. NOTE: This certification is only used when normal access to the interior of the dwelling by the City of Anaheim Inspector is not achieved during the course of project construction. It is normally used for exterior projects such as re -roofing, re -siding, patio covers, solar photovoltaic installations, and similar exterior construction work. 200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax FEB 2018 w anaheim.netlbuilding B842