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*-SNTA <br />NA.ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plara Ross Annex <br />NSP-02 20]] CRC <br />fhis document moy be lound ot..h tto:/r'r.Mr. san ta-a na.or Q/ Oba, <br />(P/ease use a black or blue ink ball-point pen) <br />Pro.ject Address: r /7a ' 0/ t' CZ e- <br />Permit N umber:0 52- <br />Property Owner:dlr\,.^ 6fh*, <br />Contractor:+t License *, LOU (( <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild in gs. <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 loca tions. <br />#\sotr' boxes below must be checked: <br />6 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 required in bedrooms with gas-fired <br />app.llances (r.e. hot water heater, cooktop, furnace) or a fireplace. <br />El Smoke 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 (SFN4). Battery life must be 10 years. <br />I hereby certjfy 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 ha ebe test e "r*tional. l, also, hereby certify that I will retest the alarms per the <br />m a n ufacturer'n ctio <br />Siqnature: <br />lcheck one)Licensed Con tra c ol P opert Owner <br />NOTE: Ihrs sef-c e rtific otion is only used lor projects that offect the ErTERIOR ol the structurc. This <br />proces; is applicable ONLY to projects where occess to the intetiot ol the dwelling by a Santa Ano <br />lnspector is not required. <br />YDote: <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 {M.19) <br />Santa Ana. CA 92702 <br />(714) 647.s800 <br />www santa-ana.orq