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*,,SAN[A <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />rNsP-02 20r3 cRc <br />This document moy be lound ot..http //wwr'. santa-a na.orq/pbai <br />(Please use a black or blue ink ball-point pen) <br />to ffifurbQ{Jua,CA <br />Permit Number:'Jt\ll71 <br />Property Owner Ba},.;TVIweovr <br />Contractor:License #: <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 sottr boxes below must be checked: <br />p Ca*on monoxide alarms: Are installed outslde 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 />apBlances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />p Smote 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. Combinatlon 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 lwill retest the alarms per the <br />ma nufacturer's nstru ct r <br />(ch eck on tr Licen sed Contractor Property Owner <br />NOTE: Ih,s sef-c ertificotion is only used for proiects thot ofiect the EXTERIOR of the strudure, This <br />process is dpplicable ONLY to prcjects where access to the interiot ol the dwelling by o Sontd Ana <br />lnspedor is not required. <br />s <br />signatu Date: <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Bor 1988 (M-'19) <br />Santa Ana, CA 92702 <br />(714) 647.s800 <br />www.santa-ana,orq <br />I <br />I <br />Project Address: ] <br />I