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*-SNTA <br />NA-'ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Sanla Ana, CA 92702 <br />(7'14) 647-s800 <br />www.santa-ana.oro <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document mdy be lound ot...httD //vwvw.santa-an a.orql obal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:fl)b 9.Dogrexl \^/A? 5ANl'rilAM 04 0A1011 <br />Permit Number: <br />Property Owner:MfuEO SOIE JK <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon rnonoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the requ ired locations. <br />f\ eotlr boxes below must be checked: <br />''ECa,ton <br />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 />appli nces (i.e. hot water heater, cooktop, furnace) or a fireplace <br />moke 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 />man ufactu rer's instructions. <br />(check onel Licensed Contractor Property Owner <br />NOTE: Ihri sef-certification is only used lor projects thdt affect the EXTERIOR ol the structurc. This <br />process is applicoble ONLY to projects wherc occess to the inteior oI the dwelling by a Sdnto Ana <br />tnspector is not required. <br />Signdture:.t&Dotej 0 <br />Have this completed form and the job-card readily available on final inspection!