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*-sAll'[A <br />NA.ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box '1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) M7-s800 <br />wllalv. sa n ta-ana. orq <br />rNSP-02 2013 CRC <br />This document moy be found at... http://w\rv/. Ean ta-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:1l1 E har- s*. <br />Permit N umber:to t1.7r.ab / zotbzlls <br />Property Owner:?eAco G";*ba <br />Contractor:S,-,.fe*i:. B"Jlers License #: ( @-7o lf <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California ResidentialCode (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 req uired locations. <br />6\ soti boxes below must be checked: <br />EPCarbon 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 />ffS.ot e 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 1.0 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 ufa ctu re r's instructio <br />(check onel e d Contractor Property Owner <br />NOTE: fh,s sef-c ertificotion is only used lor projects thot dllect the EXrERnR q the structure. This <br />process is opplicoble ONLY to projects wherc occess to the interior ol the dwelling by o Santo And <br />lnspector is not rcquired. <br />Signdture:I Dote:b(z1n <br />Have this completed form and the job-card readily available on final inspection!