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;;sffi <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647.s800 <br />'M,&W. Santa-an a.orq <br />Smoke & CO <br />Alarm Affidavit <br />tNSP-02 20r3 CRa <br />This document may be found at.hltp.ii,,'1,',.,v Sania-ana.orq/Oba,/ <br />(Please use a black or blue ink ball-point pen) <br />7(-/LProject Address: <br />Permit Number:t o t4-1(7 b <br />Property Owner:Loc f> o <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Resldential Code (CRC) Section R314.1 and 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 required locations. <br />fl eo,h boxes below must be checked: <br />[t 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 />Q Smote 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 battery-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 />manufacturer's instructions. <br />Signoture: <br />@/Date:tt -1- 20lk <br />(check onel Licensed Contracto r tr Property Owner <br />NoTE: fhrs sef-c ertificotion is only used for projects thot offect the ErTERI,R of the structure. This <br />process is opplicoble ONLY to projects where occess to the interior ol the dwelling by o Sonto Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />1 <br />tr