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*,SANTA <br />NA.TilH <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />rNsP-02 2013 CRC <br />This document moy be lound ot...http://www.santa-ana.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />(check onel Licensed Contractor Property Owner <br />NOTE: Ihis sef-c ertiftcdtion is only used lor prcjeds thot dffect the EXTERIOR oI the structure. This <br />process is dpplicdble ONLY to projeds whete dccess to the interiot oI the dwelling by o Sonto Ano <br />lnspector is not required. <br />Project Address:\\qb OfioK 4Y. <br />Permit Number:[0t{55o1 <br />Property Owner:Lr',6qe\ ho,,lY <br />Contractor:r\,^c Pero,F.^License *: lbTAO <br />Signoture:)Dote:AAr$ <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.sanla-ana.oro <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 locations. <br />A so,ir boxes below must be checked: <br />f, CarUon 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 />d SmoXealarms: 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 be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacture/s instructions. <br />tr