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*,SNTA <br />NA-hP^T <br />Planning & Building Agency <br />20 Civic Cente. Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 547.5800 <br />Smoke & CO <br />Alarm Affidavit <br />ana.orq <br />rNsP-02 2013 CRC <br />This document may be lound at...htto.//www san ta-ana.oro/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:ztfi f. Fttt rY <br />Permit Number:lol9s55z <br />Property Owner:fure*t Lcte <br />Contractor:frU loLnn-License #:164 75 7 <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 R31.4.3 and R314.3.3 define <br />the required locations. <br />f\ eoah boxes below must be checked:\J <br />A 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 />appr[iances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />L(p 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 (SFM). Battery life must be t0 years. <br />I hereby certify that I am the contractor or the property owner of the above project. lfurther 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 />man ufactu rer's instructions. <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: Ihrs sef-c ertilicotion is only used lot projects thot afiect the EXTERIOR ol the structure. This <br />prccess is applicable ONLY to prciects where access to the inte or ol the dwelling by a Sonto Ano <br />lnspedor is not required. <br />Signoture:4=Date:7/. <y'= <br />Have this completed form and the job-card readily available on final inspection! <br />tr <br />I