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INSP.O2 2013 CRC <br />This document moy be lound ot..http://www.santa-ana.o rclDbal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:t 4-t> P l+oP-u,u 12._ <br />Permit Number: <br />Property Owner:r+4*pf,/ -T"A t') <br />Contractor:License #: <br />tol tL <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 R31.4.3 and R314.3.3 define <br />the requ ired locations. <br />A ao,h boxes below must be checked: <br />,S Carton monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bbdrooms 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 />flSmoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />room, and on each levelof 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 lwill retest the alarms per the <br />ma n ufactu rer's instructions. <br />Signoture:a-'tx4- <br />lcheck onel tr Licensed Contractor Property Owner <br />NOTE: Ihrs sef-c ertification is only used lor projects thot offect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects wherc occess to the interior of the dwelling by d Sdnto Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Dote:7c1't'<- ol'- 17 <br />*,SNTA <br />NA,Tffi <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-s800 <br />www.santa-ana.olq <br />Smoke & CO <br />Alarm Affidavit <br />I <br />I