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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (ivl-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />,vir'," Sln::l-a.l.rrq <br />Srnoke & CO <br />Alari'n Affidavit <br />This document may be iound at...htta:/ ",!",v,,','. san la-a na. or <br />(p/ease use a black or blue ink ball-point pen) <br />Project Address:z:D* N-. Dr,L noa I <br />Permit Number:/o//029 tA <br />Property Owner:1,hr., $;.n <br />Contractor:c(/nr;,l;t 'r.License #, /2.< S7U <br />State of Caiifornia 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 rnonoxide alarms. CRC Section R314,3 and R315.3 define <br />the requ ire d Iocations. <br />/\{,t E Both boxes below must be checkedi <br />p 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace, <br />I Smot<e 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 />,.., +l^^ cr-L^ E:-^ nI-.-t -lr /ccnr!\ D^.!^...1i,^ -,,-r L^ rr|,,^-"-vyLiltJtoltr(Jl'Yl/.oolLc'y|JE]Uyed|J. <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 />(check one)N tcense d Co ntracto r tr Property Owner <br />NOTE: Thb seT-certificotion is only used for projecE that offect the EXTERIOR ol the structure. lhis <br />process is applicoble ONLY to projeds where access to the interior of the dwelling by a Sonta Ana <br />lnspector is not required. <br />Have this completed form and the job-card readily available oi'r final inspection! <br />Signdture:Ddte:2- /y- ?24^"/ <br />I <br />I