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*,,SANTA <br />NA <br />Itr\$c <br />ituu[\c <br />Icflfl' <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Anner <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647,s800 <br />www. santa-ana.orq <br />INSP.O2 2C13 CRC <br />fhis document moy be lound ot...h ttp://www. santa-ana.orqi pba/ <br />(Please use a black or blue ink ba -poina pen) <br />Project Address:1t t Cra,n t 5/, a. ^ +^ ltrna (A 9L* <br />Permit Number:i totctLloo <br />Property Owner:"ul'r- A *o)-urf,, <br />License #:158 reltl,t <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 R314.1. 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 />Aeo,h 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 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 pro.lect. 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 />manufacturer's instructions. <br />lcheck onel tr Licensed Contractor Property Owner <br />NOTE: Ihrs sef-c eftificotion is only used for projects thot offect the EXTERIOR of the structure. This <br />process is applicable ONLY to projects where access to the interior ol the dwelling by o Sonta Ana <br />lnspector is not reguired. <br />o7- ll- t741*Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I <br />Contractor: <br />Signoture: