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*-sAll'[A <br />NAffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(7 r 4) 647.s400 <br />ww./v santa-ana.orx <br />Smoke & CO <br />Alarm Affidavit <br />This document moy be found dt...http:/,'\,1,.,!w. sa nta-a na.orq, pba <br />(Please use a black or blue ink ball-point pen) <br />Project Address:-l( <br />Permit Number I l4i <br />s.) <br />dw..4o\ <br />L <br />llc <br />C.h-a, t jxlcn f% qzy <br />Property Owner: <br />Contractor:License #: <br />@ <br />Stete of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild in gs. <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 req uired locations. <br />A ao,!, boxes below must be checked: <br />E 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 />E 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 pro.iect. I further certify <br />that s.noke alarrns and carbo noxide alarms have been installed in compliance with the governing <br />Codes and ha,re been <br />a <br />e funct .l ere by certjfy that lretest the alarms per the <br />man ufactu re / s i <br />Signature:tJ <br />(check one)tr Licensed Contractor Proper y Owner <br />NOTE: fhls sef-c ertificdtion is only used for proieds thot alled the EXTERIOR ol the structure. This <br />prccess is opplitable ONLY tc prcjects where access tc the interior of the dwelling by d Santa Ano <br />lnspectot is not rcquircd. <br />Date: <br />Have this completed form and the job-card readily available on final inspectionl <br />INSP.O2 2C I3 CRC <br />tr