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*,,SNTA <br />NArlr,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box '1988 (M-19) <br />Santa Ana. CA927O2 <br />(714) 647-s800 <br />www.santa-ana,orq <br />Smoke & CO <br />Alarm Affidavit <br />This document moy be lound ot.http.//www. santa-ana.orqlpba/ <br />(Please use a black or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 required locations. <br />Aeoth boxes below must be checked: <br />p. 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 />J <br />lrdsmoke 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 lwill retest the alarms per the <br />manufacturer's instructions. <br />(check onel E hsed Contractor Property wne r <br />NOTE: Ihls sef-c ertification is only used for projects that affect the ErTERIOR ol the strudurc. This <br />process is opplicoble ONLY to projects where occess to the inte or of the dwelliig by o Sonto And <br />lnspector is not rcquired, <br />Project Address:t € Utir^rn'a AUe S"*{or Anr^ Tn>L <br />Permit Number:\or9 3r ) <br />Property Owner:H nroce A\\en <br />Zcvg 1:6g1c1..1 q53{ \?Contractor:License #: <br />Signoture:Dote (Lt \?Ub ? <br />I <br />rNSP-02 2013 CRC <br />tr <br />Have this completed form and the job-card readily available on final inspection!