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*-SNTA <br />NA <br />tl{\lTic <br />tiuuNc <br />lfr\0 <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) 647-s300 <br />wwr'v.saflt3-an a.orq <br />,\sP,c2 21 13 CPC <br />fhis document moy be lound ot.. <br />(Please use a black or blue ink ball-point pen) <br />i /www. santa-ana.or ba;h <br />a 6 d. C-L'er<1r^,boo 5e <br />?az" ? <br />Project Address: <br />Permit Number:O e-Q <br />Property Owner. <br />I Licen se # <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Section R3L4.l. and R315.2 states in part that existing dwellings be <br />"retrofitted wlth smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />fleorh boxes below must be checked: <br />\JCarbon monoxide alarms: Are installed outside of each steeping 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 />appy6nces (i.e. hot water heater, cooktop, furnace) or a fireplace.J\fl Smokg 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 bulldings 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 co ractor or the property owner of the above proiect. I further certifyn <br />that smoke alarms and carbon onoxide alarms have been installed in compliance with the governing <br />Codes and h tes o be functional. l, also b y certify that lwill retest the alarms per the <br />ma <br />Signotute: <br />(check onel tr Licensed Co tr ctor roperty Owner <br />NOTE: Ihis sef-c ertificotion is only used for projects thot dJfed the ErTERIoR ol the structure. This <br />process is applicable ONLY to projects where dccess to the interior ol the dwelling by o Sdntd Ano <br />lnspector is not requited. <br />Have this completed form and the job-card readily available on final inspectionl <br />L <br />acturer's i tonS <br />Dote: <br />Smoke & CO <br />Alarm Affidavit <br />I <br />Contractor: <br />I