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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-'19) <br />Santa Ana, CA 92702 <br />(71la) 6il7-5800 <br />www santa-ana ore <br />Smoke & CO <br />Alarm Affidavit <br />INSP,O2 2013 CRC <br />fhis document moy be lound ot...http://www sa nta-a na.o rqi pba,' <br />(Please use a btack or blue ink ball-point pen) <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 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 locatrons. <br />A 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 />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E 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. lfurther certify <br />that smoke alarms and carbon monoxide alarms have been lnstalled 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 />manufacturer's instructions <br />(check onel tr Licensed Contractor Property Owner <br />NOTE: Ihrs sef-certificotion is only used for projects thot oflect the EXTER,OR ol the structute. This <br />process is applicoble ONLY to projects where occess to the interiot ol the dwelling by o Sonto Ano <br />lnspectot is not required, <br />Project Address:l32t N. hl,ts-fwo ftw- 9,r1a Wta,(a ?Lto' <br />201b4-lto= <br />Property Owner:t*rll-s/eft) <br />Contractor:BMtc kr n-.License *, 4O494 <br />Signoture:(Dote b /B <br />Have this completed form and the job-card readily available on final inspection! <br />,,-SANTA <br />NAJlilll* <br />tr <br />Permit Number: