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*,SANTA <br />NA,',f,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document moy be lound dt...http //wwr.santa-ana.orqipbai <br />(Please use a black or blue ink ball-point pen) <br />/ <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 an 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 />Aeoth boxes below must be checked: <br />{C^rbonmonoxide 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 />Ef 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 1.0 years. <br />I hereby certify that I am the contractor or the property owner of the above pro.1ect. 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 lwill retest the alarms per the <br />ma n ufacturer's instructions. <br />(check onel tr Licen sed Contract 8' Property Owner <br />NOTE: Ihrs sef-c ertification is only used lor proiects thot offect the EXTERIOR of the strudure. This <br />process is opplicoble ONLY to projects where access to the interior of the dwelling by a Santa Ano <br />lnspector is not required. <br />//0/ ,U. ?azr/e,a ?/.. 5or/o 4rta. al. ?zfiProject Address: <br />Permit Number:/o/ ?45a? <br />Property Owner:,24aru'a- H. Baer- <br />a,/{cdzC License #i ,/ooLb a/ <br />7Y\o-rra--t %. B a:.t-Dote:lo/zt-/e <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) 647.5800 <br />www.santa-ana.orq <br />I <br />Contractor: <br />ISignoture: