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*-SNTA <br />NA.ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1gaa (iU-19) <br />Santa Ana, CA 92702 <br />(71.1) 647-5800 <br />,r,rf r, s r.:t-l.I lr! <br />Smoke & CO <br />Alarm Affidavit <br />INSP.O2 20I] CRC <br />This document may be lound ot..,h::3 r ,,,}ir. s3:r la-a r a.o.: cba <br />(P/ease use a black or blue ink ball-point pen) <br />t^G <br />Permit N umber:30 <br />Property Owner:fe <br />Contractor:License #: <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 />"retrofitied with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locatjons. <br />f\ eoth boxes betow must be checked: <br />Wcahon 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 />IlI Smoke alarms: Are installed in each room used for sleeping, in each ha'lway 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. lfurther 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 certjfy that I will retest the alarms per the <br />manuf acturer's instructions. <br />Signoture Dote:Z)/C <br />lcheck one Lrcen e d Con tractor P ro perty Owner <br />NoTE: fhis sef-c ertificdtion is only used for projects that offect the ErTERIOR ol the structure. This <br />process is applicable ONLY to prciects where access to the interior of the dwelling by a Sonta Ana <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: <br />I <br />tr