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Home My WebLink AboutROOF-19-2500 City of Arcadia, CA z A; PermitNO ROOF-19-2500 ;lip/ Development Services Department ry! i r a, PermitType:'Roof- • ., 240 West Huntington Drive,Post Office Box 60021 L • Arcadia,CA 91066-6021 , j a g 'i �' Work-Classifrcation Reroof assifica •on: (626)574-5416 e Permit Status.Iss ed- � , , I Expiration: �..RCf$,D�� Issue�Date 1�2 13 2019 - Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1006 ARCADIA AVE Arcadia,CA 91007-7177 5783001024, • Contacts LA CASA REAL(HOA) Owner ECONOMY ROOFING AND Contractor CONSTRUCTION 1080 CYPRESS ST M, LA HABRA,CA 90631 (626)644-5957 Description:T/O AND REROOF CONDOS(FLAT PORTION ONLY) Valuation: $ 20,000.00 Tenant WITH TORCH APPLIED BUILT UP ROOFING SYSTEM,COLOR WHITE OVER EXISTING SHEATHING. Total Sq Feet: 0.00 Plan Check ff Plan b Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $457.51 Building Permit Fees $404.25 Cash/Receipt ft REC-03356-19 $457.51 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $457.51 - 12—G34? a-/‘ t-7ecr-/fr---eifrez4),..<4; CONPLETE0 iZ-16—e? 564£ 4 I � CALLS FOR INSPECTIONS 'r(,JkL j ,6, 1,D Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. This permit/plan review expires by time limitation and becomes null and • void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. December 13, 2019 Issued By: Date December 13,2019 Page 1 of 1 ARC ��4oFF Rvief.6 d" PERMIT/PLAN REVIEW APPLICATION i, • Development Services Department,240 West Huntington Drive, Post Office Box 60021 c.°m'...,„0,14° Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia ILICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class C'3 rl License Nal o t-3 q Exp. Date 2-7A2-( compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor L3 OWNER-BUILDER DECLARATION 1.. ....______�-� El I have and will maintain workers'compensation insurance,as required by Section hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.M epi'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the .,workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole rthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Date L'L`�'! Ig Signature1. Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. E]I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: t 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new building and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. / me ,\\:, 0--- /� 9 Title c PRINT NAME certify that I have read this application and sate that the above information is correct and that I am the owner or duly authorized agent of the owner. agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upon the above-mentioned property for inspection purposes. i ature (..ThN✓N Date 1Z-( 11,`‘-s2 9 ,--:--- ..:: :),:\J ^• ________:;V. `; AFFIA AVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MtNOXIDE ALARMS Property Address: 160 to Pc-CK 0,6 Q d � et-.4 'V- pi -(hdva Cf� �\Do�- Pr op y Permit Number: 1 S' Z5-t)'0 Brief Job Description: Pe"--(2-ooF Number of smoke alarms installed: y Number of carbon monoxide alarms installed: _ When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall .be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. htt•://osfm.fire:ca.•ov/Iicensin•listin•s/licenselistin• bml searchcotest.•h• As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) ,_,_.,‘_p -._,__,_____S.„-___6_______:_________ at Arcadia, California. Owner's Name (printed/typed): N,t In Signature of Owner: This affidavit must be returned to the City of Arcadia inspector prior to final inspection ,A, pai% l'•1 ) i-taBei 41 II)kl 0 X 1 0 F.,...k,1_ .,. -,:fic ,s)C A EC)k tTh . 1; Guest Room En , i 0 , Bothroun --, u _ , Storage ' _ , — (- ...;',' ,` LA I ' . , . -- ' I ' nmity Room ! . , I ems garage -7-- .. FIRST FLOOR PLAN 1..,;.1.-. SMOKE ALARM Li tr., CARBON '.,ONOXME AL-'rslifi _ _ ..._-7.E.--.. ,a..--:.=---_--,,-- -, ,i,-------- -------!---- — --- le Mstr , v...-.-.4 I' , %....,...- Bath, I1 r I L. Master Bedroom __ __ ________ Dining Room Kitchen : - ---:- 110 .:. ,,li _ r...„.„,.., . , 1pr , , -- -, A, •,.: -_.-_- ------------,----,-- ._, , Closet 1 1 awe!. r --. 1 CIOSOt I 1 Family Room H, C , C. — , , , 'it—a- Bedroom , Bedroom 1 i 1 , - , SECOND FLOOR PLAN L ,, C .,-sMOICE AL 2,,:i.z,„ 5 CARr,ON MONOXME ALARM o t , 1 f fiy r .�-iC..T.-.e.•.its. •• . AYiY\1 i.ib) ��mais;mKp°@G AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: /.'/(.� , -zA Ac- lrithi/ 44 s9 . 7/vv7 Permit Number: 19 - 2500 Brief Job Description: 1., -aoc, Number of smoke alarms installed: Number of carbon monoxide alarms installed: 2--- When When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms; and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. http;//osfm.fire.cagov/licensinglistinas/licenselistinq bmI searchcotest,php As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. 14eciare under penalty of perjury that the fore oifg is true and correct, and that this declaration was executed on (Date) / Z z / at Arcadia, California. Owner's Name (printed/typ d): �.�.a- Signature of Owner: �CJ This affidavit must be eturned to the City of Arcadia inspector prior to final inspection -,-,,,....Re ...0................... . 1 em...1 .........FAI fa 1 1 1' GileSt ROOM Fii VW 0 ihaill'Olin [ III. I Storage 1 , t.- 1,..,... — , - -..-- ' Fatally [Warn ,-0-6-mi • 1 'Min ' MIMI 1 1•1101, Garage i 1 . FIST FLOOR PLAN t.v Ott SMOKE ALAFIM .0 tz CAO N MONOXIDE ALARM - -..---_ ,_,---.... :__1---_ :____-,-.:: .. 7_ 11::=-, ,... 14511:- ----.- - --- ' r.'-'111/11- Bab'-,_ s `. , 0, , ,, _,_,, iiimi i, aster Bedroom , m..._ _ Dining Room Kitchen -, - i-, - ' lw 1 , , ,..:. _ 1 Closet 1 Closet , , i 1 ,' 1 Family Room ow 1 I gimp'ilIMIN i 1 I --I - woo 111111.111; ... ' Bedroom ticdroom I I I Mil 1 1 I •=1.11..--.____,. -__.7.7.-_,i.. seCON* FLOOR PLAN ALAR,,', L st, CARBON MONOXIDE ALARM ... n'�:...°'° roe ',.__ AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: /00 6 . . CA44) A Ps-e. /- �Zc )e5 Ca • 9'/D0' Permit Number: 11 ' ZS00 Brief Job Description: t2 -Q.o Number of smoke alarms installed: Number of carbon-monoxide alarms installed: When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms; and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 131.13.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate• sleeping area in the immediate Vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential. Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. httpa/osfm.fire.cagov/licensinglistings/Iicenselistinq bmi. searchcotest:php As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I decI.tre under pe salty of perjury that the foregoing is true and correct, and that this declarati' n was executed on (Date) , at Arcadia, California. Owner's Name (printed/typed): /3 oAy /A( '' - Signature of Owner: ¶' This affidavit must be returned to the City of Arcadia inspector prior to final inspection .., _AL R1I i !0.) -A'0.)t, n*kioxor .4\ _ ...<.1 .1._0") ..,...A10.,:l ___ • ! Gfiest itoom ..- TA It. I, ilattirport-'! 1 -. i' i Storage d___ - . 1 .,,•, : . (3 l r.,i, _. . .. . . ._ - i ,....._. __.. . i . . . , ' . ., FunitiS. Itoorn • . . -•. - '. . ! i : :- - • ----- Gam& L_____________---___A ., __ _ . , . , MST FLOOR PLAN C'''', SjiliOts.ct ALM rifi gli = CAON Mil:N040E ALARM .. . . . -- ------- - -- • -,-...:-.-. _--_-_•-- ,--7-_-_-:-.-._.___:::::-..:_=_-_-.: =!;.:...,:-,_::::1717 .... .. _-..-.T Master Bedroani ' i , , .,„,p; i ...____ ', Dining Rooln Kitchen7 - '--1-•-:.: , ! , !! ........... , . ' - - - . ! , ..!:. 1 I HO --------- , !I Closet .1 ; r -1 , , ' ;----,WOW ..,-----,--------- !':!. •• '-: - ..!'• ' i ! FamilyRoom g _ - ---.- x___00 Bedroom i Bedroom , ! : 1 , . . *SECOND FLOOR PLM C .SMOKE ALARM ri F CAkOON MON*XiDE ALARM . ! A..01,100%:17 F lh C.'-. . ),ii Csi4S gmdas,mf�- AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND C,' "BON M•NOX DE ALARMS Property Address: 1Qo 6 CCcr 4 iNg - H cto, \\_ C4 I f/ 7 Permit Number: 1°I - D // Brief Job Description: (2 "(2-00� Number of smoke alarms installed: 2 Number of carbon monoxide alarms installed: 2. When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 131 13.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). _ Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. htt•://osfm.fire.ca.•ov/licensin•listin•,s/licenselistin• bmI searchcotest.•h As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoing is truecand correct, and that this declaration was executed on (Date) L2 J d 2 o I / at Arcadia, California. Owner's Name (printed/typed): O(1N H E---k) Signature of Ownerq-�ac-0-- . This affidavit must be returned to the City of Arcadia inspector prior to final inspection 11.4 i C Guest Room �� i ® L atht1'aan Storage_ 1 Family Roam H. -' FIRST FLOOR PLAN SMOKE ALARM L ex c :;;SON MONOXIDE ALARM --i (�4 mats Pill' - IIIII _Tr_j Master Bedroom Dining Room Bad' t, 1luii .rt- l�set ^ ,_ Closet �ioset _- ,:-�- 1 Family Hoorn 2Bedroom,I , • SECOND FLOOR PLAN �� c .S o! E ALARM a C A ...;ON MONOXIDE ALARM ,) 1 a �Ior.rv.r.lrA +i: ' N.1.r1 f.1101 yx�y� :. q,47/37;' 5 oiCOC@� . AFFl6--BAIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: /o 4vcaclia Ave. # A Arcata_. CA C/ 1 oo'7 Permit Number: I 9-1,S DO Brief Job Description: 1Lg ''vim Number of smoke alarms installed: 3 Number of carbon monoxide alarms installed: �3 When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. htt•://osfm,fire.ca.•ov/licensin•Iistin•.s/licenselistin• bml searchcotest.•h• As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. t declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) ,_)2/( 2ctf _ at Arcadia, California. Owner's Name (printed/typed): Sh/r1C —Eh/C/� Cha+'] Signature of Owner: a - c114-7-- This affidavit must be returned to the City of Arcadia inspector prior to final inspection sr o'CIE ALL AN' CAO , i 1 • 1'', Guest Room le ;1 , I liatitroutri Storage 1 . .__ 1 , .._ ; 1 ' Family itoot,11 _ , ; . I ' 11- . ; . . . - , , ,' I, , , - .._ Ft S'r FLOOR PLAN k----1 Om 6MOKE ALARM 0 er, CMISON MONOXEDE ALARM , MR- -- ------"- -----1-:-.-7-.-U',.11 .-::,&-----7-1-7:1H....‘ ,MBsatribk'-1 1 Oat 1111 , , • ' Master Bedroom 7 ,__ _ ___ __ • Dining Room Kitchen . 1, , !10 • , , 1 111111 i ,i =-_-, di , • _ .., 1 1 ta ,--.., r"..PL.,•- __ ;1 . , CIOSei 1 t 1 Hall 1 m , ' Closet . , Himon---1-: 7C-loset i- _,. , ow 1 ' 'i Family Room ism 1 • ,. . NW tool mos mot mom . , Bedroom . 111.1- Bedroom . I 1 1 1• • ... , L.----, .--...•!...-11.--.-'**7.7-----__ • S g CORD FLOOR PLAN 0 ....smCCE ALARM L., Lt. C At-,BON MONOADS ALARM t, • 7.1 fia '7 rr AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS /�AND CARBON MONOXIDE ALARMS�r9, ,o9- Property Address: 4 0 O(a t1( it IA- kr? C KI�1,P{D i b CA Permit Number: t 'Z/57;r) Brief Job Description: 12 -o..o"e- Number of smoke alarms installed: '-t' Number of carbon monoxide alarms installed: When alterations, repairs or additions requiring a permit occur,or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC)and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinityof the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code(CRC). Multi-purpose alarms(combination carbon monoxide and smoke alarms)may be used. Ali alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal h p:Nosfm.fire.ca.ctov/licensinalistinas/licenselistina bml searchcotest.�hp As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoing is true and correct,'and that this i declaration was executed on (Date) I ?i a1 E >D I i at Arcadia, California. ' Owner's Name (printed/typed): 1 !,i . 1 Signature of Owner: . isy► This affidavit must be returned to the City of Arcadia inspector prior to final inspection haps Onail.goagle.conVmaillu/UNinbox/FMfcgxwGCQbMQLFiVMDerhbEIZOKs7ProJectort il` Cid. `;.`Rd,tn#aA,• a r •''S'•: :171 '; i -1 E9 ►' t ' �e••fark `. fi AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: lOt.1 tf_a_ 4AZ Ci\b\t1 AVEa , ISe;Rc. t IN Z.A.S.‘C En Permit Number: -L1-.44,.. «'ZSbO Brief fob Description: i\l iiL1 ttv a,"Cly LLE tiv 2. a t L, L.I\`C\- ,A.O L\ tts ilyac , Number of smoke alarms installed; 4 Number of carbon monoxide alarms-iris-Wed: When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. htto.llosim.firg,ca.aov/licensinolistins/licenselistinq bm1 searchcotest.php As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) t. ZL 2 ! f l at Arcadia, California. • Owner's Name (printed/typed): i Rd 77'tet= S i Ye L Signature of Owner. ' This affidavit must be returned to the City of ii 6=dia inspector prior to final inspection