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*-SNTA <br />NA,ffi <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 92702 <br />(714) M7.5800 <br />-ana.olq <br />INSP.O2 2013 CRC <br />fhis document moy be lound ot..htto;//www santa-a na. oro/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:223t) S Cv P,'t"-.-, Av <br />Permit Number:2Ataq z3q <br />Property Owner:Ara ()anst kP h ran <br />Contractor:Ot<: n e-v'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 requ ired locations. <br />f\ eoth 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 />FSmote 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. lfurther 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 instructions. <br />(check onel tr Licensed Contr Property Owner <br />NOTE: Ihrs sef-c ertificotion is only used for projects that offect the EXTERTOR of the structute. This <br />prccess is opplicoble ONLY to projects where occess to the inteior of the dwelling by a Sontd Ano <br />lnspectot is not tequited, <br />Signature:ry Dote:'c - l?- t+ <br />Have this completed form and the job-card readily available on final inspection!