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-,'$ANTA <br />NNqffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Cento. Plaza Ross Annex <br />P.O. Box 1988 (il-19) <br />Santr Ane, CA 92702 <br />01/a) 647-sE0O <br />www.santa.ana.oaq <br />a <br />rNsP42 2013 CRC <br />fhis dodrment moy ba lound oL-.htto ://www. santa-ana.oro/pba/ <br />(Prease use a black or blue ink balbpotnt pen) <br />Permit Number: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />Califomia 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 />f|** *r.s betow must be chected: <br />E Crrt"n monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />b€drooms 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 Sntot" alanns: 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 iomply with all applicable standards and be approved <br />by th€ State Fire Marshall (SFM). Battery life must be l0 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 goveming <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />manuf acturer's anstruct ns. <br />Signotwe: <br />lcheck onel Licensed Contractor tr Property Owner <br />NOTE: fhis serrr ertificotion is only used lor projects thot atfed the ErTERIOR of the structure. fhis <br />process is opplicable ONLY to projects where occess to the interiot of the dwelling by o Sonto Ana <br />lnspeclor is not rcquircd. <br />Project Address:V47? \i (artrl,;r ?t. S.r,'H Ar4t <br />to\4s tlt <br />Property Owner: <br />Contractor:\'d{t, , (t*{ iru | uconre * fl,ff lt <br />Dote l,) l,? l,,l/+ <br />y"ave this completed form and the job-card readily available on final inspection ,Y <br />$ft't