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*,,SANTA <br />NAqffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(71.r) 647.5800 <br />w\rw.santa-ana.otq <br />Smoke & CO <br />Alarm Affidavit <br />INSP.O2 2013 CRC <br />lhis document moy be lound ot.h ttp:/i ww,v. santa-a na.orqi pba, <br />(Please use a black or blue ink ball-point pen) <br />Project Address:<l< A. (11-/h-,^\iF^\ <br />^\L,--Permit Number:lotqqq*1 <br />Property Owner:L A(o <br />Contractor:License #: <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 />Aeoth boxes below must be checked: <br />I C..ton 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-fjred <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />A, <br />F[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. 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 lwill retest the alarms per the <br />ma n ufactu re r'.st ru tio <br />lcheck onel tr Licensed Contractor ope OwnerP <br />NOTE: fhrs self-ceftificotion is only used lor projects thot oflect the EXTERIOR of the strudure. lhis <br />process is opplicoble ONLY to projects where occess to the interior ol the dwelling by a Sdnta Ano <br />lnspedot is not rcquircd. <br />Signoture:Dote:lo <br />Have this completed form and the job-card readily available on final inspection! <br />tr