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*,,SANTA <br />NA,\'ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box '1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />www.santa-ana-orq <br />rNsP,02 2013 CRC <br />This document moy be found dt..http://www. gan ta-a na.orqi pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address:\o1G S \hqwnec D< <br />Permit Number:lio fi5tt< <br />Property Owner:J SSZL-e,*recce+ <br />Contractor:T?uEf CqLr("rni {License *: \6o!J4t <br />State of California requires that smoke and carbon 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 R31.4.3 and R314.3.3 define <br />the requ ired locations. <br />A eo,h boxes below must be checked: <br />--Eltarbon 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 />-€l'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 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 lwill retest the alarms per the <br />ma nufactu re/s instructions. <br />tr rcen Co n tracto r Property Owner <br />NOTE: Ihis sef-certificotion is only used lor projeds thdt olled the EXTERIOR of the strudure. This <br />process is opplicoble ONLY to proiects where occess to the interior of the dwelling by o Sdnto Ano <br />lnspedor is not required. <br />Signature <br />I <br />I oote: <br />I I <br />lcheck onel <br />Have this completed form and the job-card readily available on final inspection!