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*-SNTA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2011CRO <br />fhis document mdy be lound ot...hftc./,w.1,'l santa-ana.orqi oba,' <br />(Please use a black or blue ink ball-point pen) <br />Project Address: 2l 0 _{ tU 7f,9A/\/fA Aua ?J)o\ <br />, Permit N umber:totqaq 4o <br />Property Owner:*/\/A t/u <br />C o ntractor:Lice nse #: <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 R314.3 and R314.3.3 define <br />the required locations. <br />f\ so,i, boxes below must be checked: <br />E 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 gls-fired <br />appliances (i.e. hot water he3ter, cooktop, furnace) or a fireplace. <br />E 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 10 years. <br />I hereby certify that I am the contractor or the property owner of the abo,re 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 />ma n ufacturer's instructions. <br />5ig n dture:C)-*/*Dote: At re I JOr-lI <br />lcheck one)D Licen sed Contractor E Pro perty Owner <br />NOTE: fhls sef-c ertificotion is only used t'or proiects thot dlfect the EXTERIOR of the structute. lhis <br />process is applicoble ONLY to prcjects where access to the interior ol the dwelling by o Sontd Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />II <br />t <br />P.O. Box '1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />w.r ,v santa-ana.orq