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*,,SANTA <br />NA,"'|,ffit <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />INSP{2 2013 CRC <br />This document moy be lound ot... h tto://www. Sa nta-ana. orqi pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address:gk{i 3 SeXe bB- (norra F,-A AA ciz?"q <br />Permit Number:\ot,1 ]i'.to <br />Jv)v I -\t?€/t- Y{LL <br />License #: <br />Property Owner: <br />Contractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u 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 monoxlde alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />f) sorr, boxes below must be checked: <br />EI 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 />apptiances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />d S-ot" 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 certlfy 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 />lcheck onel I Licensed Contractor Property Owner <br />NOTE: Ihrs sef-certificotion is only used for projects thot offect the EXTERI9R oI the structure. This <br />prccess is opplicoble ONLY to prcjects wherc occess to the interior of the dwelling by a Santa Ana <br />lnspectot is not rcquired. <br />Signdture:Dote:1 I t1ZO <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />IP.O. Box l988 (M.'19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www.santa-ana.ora