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.--SANTA <br />NA <br />[r\]nc <br />&But0n-c <br />lGt\0 <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www.santa-ana.otq <br />rNSP-02 2013 CRC <br />This document moy be lound ot...htto://www.santa-ana.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:a <br />Permit Number:i'o t ial 1 <br />Property Owner: <br />Contractor:License #: <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 aoth boxes below must be checked: <br />ACarbon 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 />,ipsmote 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 pro.iect. 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 />ma nufactu rerl instructions <br />lcheck onel tr Licensed Contractor Property O wner <br />NOTE: Ihis sef-certification is onty used Iot prcjeds thot ofled the EXTERIOR of the strudute. This <br />process is opplicoble ONLY to projeds wherc occess to the inte or ol the dwelling by a Sonto Ano <br />lnspector is not required. <br />Signoturc:Dote:3r( H,2atr <br />Have this completed form and the job-card readily available on final inspectionl