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*-SNTA <br />NA <br />ll$\N <br />ln[.0M <br />ffrtl' <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (H.19) <br />Santa Ana, CA 92702 <br />(714) 6il7-5800 <br />'r'.! // 5-rnl t-3n3 0rq <br />Smoke & CO <br />AIarm Affidavit <br />fhis document moy be lound at... http / ;1",1;',^i Santa-ana orq/pba.' <br />(please use a black or blue ink ball-point pen) <br />ua N HcV 61 4fitt ANA .Ll q1?o1- <br />bLq\BL I <br />Property Owner:t',4t16, C l,ilC,'lrh <br />Contractor:&M.ilti(;t rdtn iLicense o' !pt7-5\O <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u 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 R315.3 define <br />the required locations. <br />A ao,ir 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />ESmoke 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 an <br />Codes and have been <br />d carbon mo <br />ted <br />ide alarms have been installed in compliance with the governing <br />ctional. <br />lcheck onel Licensed Contractor tr Property Owner <br />NOTE: Ihis sef-certification is only used lor projeas thdt offect the EXTERIOR ol the strudute. This <br />process is opplicdble ONLY to ptojeds where occess to the interior of the dwelling by a Sonto Ana <br />lnspectot is not rcquircd. <br />Signotute:Ddte:3- 2z-Zo9 <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />Project Address: <br />Permit Number: