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*-SNTA <br />NA.ffi <br />Smoke & CO <br />Alarm AffidavitP.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />ta-ana.orq <br />tNSP-02 2013 CRC <br />This document moy be found at...http:i/www .santa-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:l8l3 v. S'1. n*4t221.r ?L <br />lo llzteoPermit Number: <br />Property Owner:Ita \\;f, <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Section R3l.4.1and 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 requ ired locations. <br />A so,tr 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 />apyliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />d Srnot " alarms: Are installed in each room used for sleeping, in each hallway outside ot a sleeprng <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 Iwill retest the alarms per the <br />man ufactu rer's instructions. <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: Ihrs sef-certification is only used for prcjects thot olfect the EXTERTOR of the structure. This <br />process is applicoble ONLY to projects where dccess to the interior ol the dwelling by o Sonto And <br />lnspector is not requircd. <br />Date:1-z,t- 11 <br />Have this completed form and the job-card readily available on final inspection! <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />I <br />I <br />I <br />I signoture: