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*,SNIA <br />NAffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Anner <br />P.O. Box '1988 (M-19) <br />Santa Ana. CA92702 <br />(714) 647-5800 <br />w.M?v santf-an3.olq <br />INSP.O2 2013 CRC <br />fhis document mdy be found ot.h ttD./r'vl/iv)v. sa n ta-a na.orqi pba,' <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address tt D (ri <br />Permit Number:i oxqq/rlz <br />Property Owner:nla LJ^ o- lwa,.t fl,t+t <br />Co ntractor: <br />I <br />t <br />I <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California Residential Code (CRC) Section R3l.4.1and 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 />f,\eoth boxes below must be checked: <br />E 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 />apgliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E[ Smot e 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 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 n ufactu rer's instruc ons <br />lcheck onel L ensed o ntractor Pr pe rt wne r <br />NoTE: fhis sef-certificdtion is only used for projects that dflect the EXTERIOR of the sttucture. This <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by d Sdnta Ana <br />lnspector is not requited. <br />Signdtute:Dote:3/rq / tt <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />License #: <br />tr