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Planning & Building Agency <br />2: Civic Center Piaza Rcss Annex <br />P.O. Box '!988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />,w^a/.santa-ana.ort <br />Smoke & CO <br />Alarm Affidavit <br />;\sP-c2 2a'3 i?a <br />This document moy be found at.., <br />(Please use a black or blue ink ball-int pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that eiisting dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R3L4.3 and R314.3.3 define <br />the required 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 />edrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appllances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E Smoke 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 t contractor or the property owner of the above project. I further certify <br />that smoke alarms and n monoxide alarms have been installed in compliance with the governing <br />Codes and have been te <br />manufacturer's instructi <br />d to be functional. l, also, hereby certify that I will retest the alarms per the <br />lcheck onel Lic sed Contractor Prope y Owner <br />NOTE: Ihis sef-certificotion is only used for projects thdt dffect the EXTERIOR of the structure. This <br />process is applicdble ONLY to proieds where access to the interior oI the dwelling by a Santa Ana <br />lnspector is not required. <br />s <br />Project Address:O- <br />Permit Number:Dtl-l2o( <br />Contractor:License #:(- <br />Signoture:Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />*,SNIA <br />NAJhffi <br />yl a,<-t <br />lAl<"(\ <br />Property Owner: <br />I