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*-SANTA <br />NAJ}Hil <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Clvlc Center Plaza Rosg Annex <br />P.O. Bor 1988 (M-19) <br />santa Ana, cA 92702 <br />(7r,r) 647.5800 <br />ww\rY.santa-ana.orq <br />rNSP{2 2013 CRC <br />This document moy be tound ot..-htto ://www. santa-ana.Dba/ <br />(Please use a black or blue ink ball-potnt 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 R314.1 and 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 />Aaoth boxes below must be checked: <br />(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, fumace) 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. lfurther 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 />manufactu re ctions <br />x <br />tr Licensed Contractor E Pro e Owner <br />Project Address:Jqas-F.r _s c\frylo <br />Permit Number:t* iolclsTdb <br />e^-.L hdcrlltt <br />Contractor:Ra)fslLicense #: Q <br />Date ,Jot,l tg <br />Have this completed form and the Job-card roadily available on final inspection! <br />Property Owner: <br />Signotute:I <br />(check onel <br />*Or ure, fhis <br />process is opplicable oNLY to prciects where access to ahe inte ot oI the dwe ing by o sontd Ano <br />tnspector is not rcqulred, <br />I