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*-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, CA92702 <br />(714)647-5800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />NSP-02 2013 CRC <br />This document moy be lound ot...httD:/iwww. santa-a na orolobal <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:U)q N Eil<t-uriD 9t <br />Permit Number:htqu,-{3 <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and 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 sott boxes below must be checked: <br />El 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 />appliances (i.e. hot water heater, 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 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 ufactu rer's instructions. <br />(check onel Licen sed C on tractor F Pro perty Owner <br />NOTE: Ihis sef-c ertilicotion is only used for prcjects thot olfect the EXTERIOR of the structure. This <br />process is applicable ONLY to ptojects where occess to the inte or of the dwelling by o Santd Ano <br />lnspector is not required. <br />s-3o-ll/Signoture: <br />I <br />I <br />I <br />I <br />I <br />, Property Owner:I <br />Dote: <br />I <br />v <br />X'r"* this completed form and the job-card readily available on final insnectionr{ <br />---