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*,,$AI{TA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />NSP-02 2013 CRC <br />This document may be found ot..h ttc:/i,,v,,v,,v. s a n ta -a na. o rq,/pba.' <br />(Please use a black or blue ink ball-point pen) <br />/,2O tt \i\i e-s Larir . A r)" <br />Permit Number:loi9 P,^z-8'i <br />Property Owner:d c-r-l-- <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the req u ired locations. <br />f,l ro,n boxes below must be checked: <br />EI Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Z Smoke 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 b atte ry-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 />man ufacturer's instructions. <br />(check onel tr Lice nsed Contractor Pro perty Owner <br />NOTE: fhis sef-certification is only used for projects thot dflect the EXTERIOR of the structure. This <br />process is applicoble ONLY to ptojects where access to the interior oJ the dwelling by o Santa Ana <br />lnspector is not required, <br />Signoture:)/tl /rqlrRDote: <br />Have this completed form and the job-card readily available on final inspection! <br />P.O.8ox 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />,rr''r'l,I/. s a n ta-an a.ora] <br />Project Address: <br />I