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-,,$ANTA <br />NAqffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. 8ox 1988 (ll-19) <br />Santa Ana, CA 92702 <br />Fr4) 647.s800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNsP{2 m13 CRC <br />This document moy be fuund ot..httD r/www. sa nta-ana.oro/pba/ <br />(Please use a black or blue ink bell-point pen) <br />Project Address:)jJlNl (otVnr.ilrr,z:-,( $.9,rr\r,' A"r,{, CA <br />Permit Number:lot149@ <br />Property O,\flner: <br />Contractor:S,(OW ?<r{lnc lucense*: clt"4o,1, <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 monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />f|*,n *ro betow must be chected: <br />F a* monoxide alarms: Are installed outside of each sleepang area in the immediate vicinity of <br />bidrooms and also on each level of the dwelling. Alarms are required in bedrooms with 8as-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />psnrof" alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />[oom, 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 lafe must be 10 years. <br />I hereby certiry 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 goveming <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacture/s instructions. <br />lcheck onel Licensed Contractor tr Property Owner <br />NOTE: fhis serf-certificotion is only used lor projeas that olled the EXTERIOR ol the strudure. Ihrs <br />process is opplicable ONLY to projects where occess to the inte ot of the dvelling by o Sonto Ana <br />tnspector is not required. <br />I (Dote T ltll t+ <br />%ave this completed form and the job-card readily available on final inspection ,Y <br />I <br />Signoture: