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*O'SNTA <br />NAJIffi <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-s800 <br />www.santa-ana.o rq <br />tNSP-02 2013 CRC <br />This document moy be lound at... h ttp://'M/v\iv. Sa nta-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2A<c S. _sfrLTfr oT <br />Permit N umber:1o rV 40 7/ <br />Property Owner:Oftvio Rto 5 < oR TzZ- <br />Contractor:'lafiZ Rccfril,License *: // VZAj <br />State of California requires lhat 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 sotlr boxes below must be checked: <br />! 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 />E Smoke 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 />manufacturer's instructions. <br />(check onel cenSe d ntractor Property Owner <br />NOTE: Ihis sef-c ertificdtion is only used Jor projects thot affect the EXTERIOR ol the structure. This <br />process is applicoble ONLY to projeas where occess to the interior of the dwelling by a Sonto Ano <br />lnspector is not required, <br />Signature:7 <br />Have this completed form and the job-card readily available on final inspection! <br />tr <br />I oate, I