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**SNIA <br />NA.ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Anner <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA92702 <br />(714) M7.5800 <br />wiv.r/. santa-a n a. orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP-02 2013 CRC <br />This document moy be lound at...h tto:/A,,rvivr. sa n ta-ana.orq/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:I U), Vgn\ lr,/L %trta- *\" A4- qlfat <br />Permit Number:I <br />Property Owner:AAcolJ€vtNE e*O <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide {CO) alarms are installed in residential <br />bu ild ing s. <br />California Residential Code (CRC) Section R3l.4.1and 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 req uired locations. <br />f\ aoth boxes betow must be checked: <br />F.-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. AIarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />B S.of" 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 be functional. l, also, hereby certify that I will retest the alarms per the <br />ma n ufactu rer's instructions. <br />(check onel Lice n se d Contra Property Ownerc <br />NOTE: fhis sef-certification is only used for projects thdt aflect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior ol the dwelling by a Sontd Ano <br />lnspector is not required. <br />J\-... <br />Sig ndtu re:ty <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I <br />\<t