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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 />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www.santa-ana-orq <br />Smoke & CO <br />Alarm Affidavit <br />lNsP-02 2013 CRC <br />This document moy be lound at.http://www.santa-ana.or q/pbai <br />(Please use a black or blue ink ball-poinl pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Section R3l.4.1and 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 />A ao,rr boxes below must be checked: <br />XCarbon 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 />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />F{ Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />rodm, 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 />ma n ufacturer's instructions <br />Signoture: <br />lcheck onel Licen sed Contractor tr Property Owner <br />NOTE; fhis sef-c ertificotion is only used for projects thot dflect the EXTERIOR of the structure. This <br />process is applicable ONLY to prcjects where dccess to the inte or oI the dwelling by o Sontd And <br />lnspectot is not required. <br />Project Address:l<t( S <wr*raa.<c ,l .onh A,./A <br />Permit Number:to./ 4t{9b)o lro'2qo 1 <br />Property Owner: <br />SwnJ-at t--n.*, Lt License #: <br />L-/t -/7 <br />I <br />Contractor: <br />Dote: <br />Have this completed form and the job-card readily available on final inspection!