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*,,SNIA <br />.NA.ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.s800 <br />www,santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />tNSP-02 2013 CRC <br />This document moy be lound at...htto :/iwv/w. sa nta-ana.orq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />State of California requires that smoke and ca on 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 />fl eoth boxes below must be checked: <br />frC.rionmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />b\drooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appl ces (i.e. hot water heater, cooktop, furnace) or a fireplace <br />Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />m, 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 ilarms 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 re r's instructi <br />lcheck onel F Licen sed C ntra or P(pert Owner <br />NOTE: Ihis sef-c eftificotion is only used lor projects thot offect the EXTERIOR ol the structure. This <br />process is opplicable ONLY to projects where access to the intetiot ol the dwelling by a Sonta Ano <br />lnspector is not rcquircd. <br />ro <br />r Project Address:tzb CLE ff'=-t\l.rt^l AVt <br />Permit N umber:2d lZnSt-2- <br />I Property Owner:BSVA\l P4A>t aU1 <br />'Contractor:.\zS,r 9 lJ<1r't--License #, ( /0 f AgB <br />Signature:)Dote:// <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I