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I <br />II <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) 6i17.5800 <br />www.santa-ana,orq * <br />Smoke & CO <br />Alarm Affidavit*-SNTA <br />NAqffi <br />rNSP-02 2013 CRC <br />fhis document moy be found ot...http ://vwwv. san ta-ana.orq/pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address:40t s.llllngttr,tAt <br />Permit Number:I hsq zq'? x <br />Property Owner:Qnilan v, ,Qseps <br />Contractor:/)<e koorult License #:8tt"tJ9 <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 R314.3 and R314.3.3 define <br />the required locations. <br />A ao,h boxes below must be checked: <br />fll 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 />d 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 L0 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 />manufacturer's instructions. <br />(check onel Lrcensed Contractor Property Owner <br />NOTE: Ih6 serl-c ertilicdtion is only used fot projects thot alfed the EXTERIOR ol the strudure. This <br />process is opplicdble ONLY to projeds whete dccess to the interior of the dwelling by o Sontd Ano <br />lnspectot is not required. <br />Signature:'),6 lolei;o,r <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I <br />I Dot"'