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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box '1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />j3tt N, ?oinrett.. .rt <br />Permit Number:[otl 03rY 6 <br />Property Owner:Jo'Le'€r <br />Contractor:Drongs 4,q,,{-7 &k e License #,18,'1t>Z <br />tNSP-02 2013 CRC <br />This document mdy be lound ot...htto://www santa-ana.oro/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 requ ired locations. <br />f\ sottr boxes below must be checked: <br />fuC"rUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bebrooms 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 />A <br />{ Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />robm, 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 lwill retest the alarms per the <br />ma n ufacturer's ins ctio s. <br />Lice n se Contractor tr Property Owner <br />NOTE: Ihis sell-certification is only used for projects that offect the EXTERIOR of the structure. This <br />process is opplicable ONLY to prcjects where access to the interior oI the dwelling by a Sonto Ana <br />lnspector is not required. <br />Signoture:A I Date 2.Z8.zt) <br />Have this completed form and the job-card readily available on final inspection! <br />,-,SANTA <br />NAJlffii <br />Project Address: <br />lcheck onel tr