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*,,SANTA <br />NA,I[W <br />Planning & Building Agency <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. sa nta-ana, or <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />fhis document moy be found at..http ://wI^,,/. sa nta-a na.orq/pba/ <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 />b u ild ings. <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 />A so,i boxes below must be checked: <br />fi C"rton 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 />rl <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. 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 />ma nufacturer's inst uctions <br />lcheck one\ensed Contractor Property Owner <br />NOfE: This seU-certificotion is only used lor prcjects thot offect the EXTERIOR of the structute. This <br />process is applicoble ONLY to projects where dccess to the interiot of the dwelling by d Sontd Ano <br />lnspector is not rcquired. <br />Project Add ress:c\\cr.5t.L 5 <br />Permit Number: <br />"toProperty Owner:i 11 <br />Contractor:lru (\T1#Licen <br />Signotute:fifla{v-Dote:b?ttt+ <br />7 <br />tr <br />Yr^t.this completed form and the job-card readily available on final inseection{