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,**SNTA <br />NAJhIffi <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 92?02 <br />(714) 6il7-5800 <br />www.sanla.ana.olq <br />rNsP 02 2013 CRC <br />This document moy be lound ot... http://www.santa-ana.orq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:E 07 V v/e,l-.\^./t,^,1 <br />Permit Number:0l al <br />Property Owner:c(<Lfvl"{y^] License *: /3J - OLtOContractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ing s. <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 ao,r, boxes below must be checked: <br />E Carbon monoxide alarms: Are installed outsrde 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 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 I will retest the alarms per the <br />ma n ufactu rer's i uction s <br />lcheck onel Licen sed Contractor Prope o wner <br />NOTE; Ihrs sef-certification is only used for proiects thot dflect the EXTERIOR of the structure. This <br />process is opplicable ONLY to prcjects where occess to the interior ol the dwelling by o Sonta And <br />lnspectot is not required. <br />Dote:t /rt/ rz <br />Have this completed form and the job-card readily available on final inspection! <br />l <br />I Signoture: / -- <br />tr