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*,SNTA <br />NAffi <br />ta t <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box I 988 (M-19) <br />Santa Ana. CA92702 <br />(714) 647-s800 <br />ww'iv.santa-ana. orq <br />Project Address:\o 33 w Cu5\, \./u^ <br />Permit Number:2o\\r350 Z <br />\.^,r,rrr-S \\ i\\ <br />Contractor:s.rvr\tJx tr,fwqA License #:\ clo(1lLl <br />rNsP-o2 2013 CRC <br />f his document mdy be found ot...h ttp ://v'r,,r,,r. santa -a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />State of California requires that smoke and carb n monoxide (CO) alarms are installed in residential <br />buildings. <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 req uired location s. <br />€\r*nboxes below must be checked: <br />El4rrbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedr <br />appli <br />oonitS <br />es (i.e, <br />also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />hot water heater, cooktop, furnace) or a fireplace. <br />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.ject. 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'nstructions. <br />lcheck one)Licensed Contractor tr P roperty Owner <br />5Se lf-certification is only used lor prcjects that aflect the EXTERIOR oJ the structure. This <br />process is applicable ONLY to projects wherc dccess to the interior ol the dwelling by o Sonto Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Sig ndtur e:Dot e:'7/ <br />Smoke & CO <br />Alarm AffidavitI <br />I <br />I Property owner: <br />I <br />N OTE: