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SNIA <br />NA,ffi <br />OiIOI <br />Planning & Building Agb cy <br />20 Civic Center Plaza Ross Anne{ <br />P.O. Bor 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.s800 <br />w.l./v. s tn ta-a n a - oro <br />Smoke & CO <br />Alarm Affidavit <br />rNSP{2 2013 CRC <br />This document mdy be lound ot...h ttp:/4,1n,' i /.santa-ana.or qlobal <br />(P/ease use a black or blue ink ball.point pen) <br />Contractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 required locations. <br />6\ eoth boxes betow must be che#: <br />14 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. Alalms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />flSmoLe alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />/room, aad 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). Eattery life must be 1b years. <br />I hereby certify that I am the contractor or the property owner of the above 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 I will retest the alarms per the <br />manufacturer's instructions. <br />lcheck onel Licen s e ntractor Prope yow ( <br />)1 <br />NorE: rhis se,/-c ertification is only used for projects thot oIIect the ExrER!oR ol the structure, This <br />process is applicdble ONLY to projects where occess to the interior ol the dwelling by a Santd Ana <br />lnspedot is not tequired., <br />w <br />-1 <br />Project Address:Li <br />Permit Number:olg <br />Property Owner:EI 0 Vanr+ <br />License #: <br />Signdture:Daty obltr t-1 <br />Have this completed form and the job-card readily available on final inspection! <br />I