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Planning & Building Agency <br />20 Civic Center Plaza Hoss Annex <br />P.O. Box ,988 (tl-rg) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.sanla-ana.oro <br />Smoke & CO <br />Alarm Affidavit <br />This document moy be found ot...http ://www. santa-ana.oro/pba/ <br />(please use a black or blue ink ball-point pen) <br />Project Address:22o1 rt F 6,-ufl-ST <br />Permit Number:2ol6sqo:l <br />Property Owner:Ro(kflf ArsBuctlo'"t <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 />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R315.3 define <br />the required locations. <br />A eo,h boxes below must be checked: <br />M 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 />aOfliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />dsmoke 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 and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to b nction a I <br />lcheck onel Licensed Contractor Property Owner <br />NoTE: Ihis sef-certificotion is only used fot projects thot dlfed the EXfERIOB oI the strudure. This <br />prccess is opplicoble ONLY to projects wherc occess to the inte ot of the dwelling by o Sonto Ano <br />lnspedor is not requircd. <br />Have this completed lorm and the job-card readily available on final inspection! <br />Signature:I v_.Date:slrqltU <br />-,-SANTA <br />NAJI[#