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**SNTA <br />NA,tffi <br />Planning & Building Agency <br />20 Civic Center PIaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-s300 <br />wwrar.santa-ana.olq <br />Smoke & CO <br />Alarm Affidavit <br />rfrSP-02 2013 CPa <br />This document moy be lound ot... <br />(P/ease use a black or blue ink ball-point pen) <br />htto:/rww!,i. sa nta-ana.oro.,oba/ <br />Project Ad dress:a\ oq r/t s9 <br />r Permit N umber: <br />y Owner ;J,*- <br />Contractor Lice nse #4 7? <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 required locations. <br />A eoth boxes below must be checked: <br />E Carbon monoxide alarms: Are installed outside of each sleepinB 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 />E Smok2alarms: 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-operat€d 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 />ma nufactu rer's instructions. <br />Signoture: <br />lcheck onel I Licensed Contractor tr Pro e rty wner <br />NOTE: Ih,s sef-c ertilicotion is only used lor projects thot offed the EXTERIOR of the sttucture. This <br />process is dpplicable ONLY to projects where dccess to the interior oI the dwelling by a Santa And <br />lnspector is not required. <br />0h--/0Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />I