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-,-SANTA <br />NA <br />PLITINC <br />& [III,DIIG <br />IGt\CI <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (Ml9) <br />Santa Ana. CA 92702 <br />(7r4) 647-5800 <br />www.santa-ana.orq <br />Project Address: <br />Permit Number: <br />Property Owner: <br />Contractor:License #: <br />tNSP,02 2013 CRC <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.L and R31"5.2 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 requ ired locations. <br />Both boxes below must be checked: <br />Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bed rooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />ap ances (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 />p erformed. Combination Smoke/CO alarms must com ply with all applicable standards and be approved <br />by the State Fire Marsha ). Battery life must be 10 years <br />I hereby certify that e contractor or the property owner of the above pro.ject. I further certify <br />that smoke alarm rbon monoxide alarms have been installed in compliance with the governing <br />Codes and have sted to be functional. l, also, hereby certify that I will retest the alarms per the <br />man ufacturer'ctions <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: fhrs serl-certilicotion is only used fot projects thot ollect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by a Sdnto And <br />lnspector is not tequired. <br />m <br />an d <br />tns t <br />een <br />Signdture: <br />,,4 <br />Date: <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />This document moy be lound dt... htto.//www.sa nta-a na.oro/pba/ <br />(Please use a black ot blue ink ball-point <br />tr <br />//nftdos75 <br />-TAF/-L <br />4