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*,,SANTA <br />NA-"ffitr <br />Plannlng & Building Agency <br />20 Clvlc Center Phze Ross Anner <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92T02, <br />ol4) 047€800 <br />www.santa-ana.oro <br />Smoke & CO <br />Alarm Affidavit <br />This document moy be found oL- http://www.santa-ana.org/pba/ <br />(please u* a black or blue ink Mllpoint pen) <br />Prolect Address:15 io N Sonho.q o S+ <br />Permlt Number:\otto3'{8o <br />Property Owner:kevtn <br />Contractor:Pre .., i u* Rorfi " j (y..{"-s License#: loqlz\L{ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential 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 R315.3 define <br />the required locations. <br />Aao,h boxes below must be checked: <br />FCarUon monoxide atarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />FSmote atarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping'room, and on each levelof 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. <br />lcheck onel tr Licensed Contractor Property Owner <br />NOTE: Thts seff<erttficatlon ls only used lor protects thqt offect the EXTERTOR ol the $ruaure. This <br />proaess is applicoble ONLY to projeds where occess to the lnterior olthe dwelling by o Santo Ano <br />tnspector ls not requlred. <br />Have this completed form and the job-card readlly available on llnal lnspectlon! <br />Signoture ,re-Dote:,1 I I Za <br />l