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*,,SANTA <br />NA <br />ll-r\lN <br />& BIIIJIIG <br />$n0 <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) 647-5800 <br />www santa-ana.orq <br />rNsP-02 2013 CRC <br />This document moy be lound ot...htto://www. sa nta-a na.o rqlobal <br />, <br />(Please use a black or blue ink ball-point pen) <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 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 />Asott boxes below must be checked: <br />ff CarUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />6"tr.oort 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 />9Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />'6ecr, 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. 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 />m an ufacturer's instructions. <br />lcheck onel Lice nsed Contractor Pr p rty Owner <br />NOTE: Ihis sef-certificotion is only used for prcjects thot olfect the EXTERIOR oJ the structure. This <br />process is applicable ONLY to projeds where occess to the interiot ol the dwelling by o Sonto Ana <br />lnspectot is not required, <br />Project Address:a-ao\ N L<rrt^L I <br />Permit Number:^lo t4ll-qq <br />Property Owner:,.1-;,J" w-rvr!-, <br />Contractor:Anr,*^- / a-,-l License #:looT qo= <br />Signature:\w--Dote:/,la <br />Have this completed form and the job-card readily available on final inspection! <br />I I <br />I1