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) <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex -Smoke & CO <br />Alarm Affidavit*,SNTA <br />NATffi <br />tNsP-02 2013 CRC <br />htto://www santa-a na.orq/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:((L- C- q ARj\/ge\.r 5ar,<7-a. A*6 <br />Permit Number:o <br />Property Owner: <br />Contractor License #: <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 sott, boxes below must be checked: <br />@ Cafton 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 />*^olr"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 ba ttery-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 prolect. 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 />man ufactu rer's instructions. <br />lcheck onel PLicensed Contractor Property Owner <br />NOTE: Ihrs sef-certificotion is only used for projects thot offect the EXTERIOR ol the structure. This <br />process is opplicable ONLY to projects where occess to the interior ol the dwelling by o Santo Ano <br />lnspector is not required. <br />Signature:1- Lt-tz <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />This document moy be lound ot... <br />I <br />I <br />I Dote: <br />I