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rNSP-02 2013 CRC <br />http://www.santa-ana.orq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address Dtr l.)-r+t l\) <br />Permit Number:ro\rrYl )t-l9 <br />Property Owner:CI^odoj+ <br />Contractor:Bv <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <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 requ ired locations. <br />6\ sotl, boxes below must be checked: <br />E 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. Alarms are required in bedrooms with gasJired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />$S.ot e 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. Combinatlon 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 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 lwill retest the alarms per the <br />ma n ufactu rer's instruction <br />lcheck one\tr Licensed Contractor Property Owner <br />NOTE: fhrs serf-c ertification is only used Jor projects thdt afiect the EXTERIOR of the structure, This <br />process is opplicable ONLY to projects where access to the interior of the dwelling by o Sdnta Ana <br />lnspectot is not requited. <br />Signature:/-J,l <br />Date:L -zD-/? <br />*,,SNTA <br />NAffi <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) 647-5800 <br />www.santa-ana.orq <br />Smoke & CO <br />AIarm Affidavit <br />This document moy be lound ot... <br />License #, ql1 <br />tr <br />Have this completed form and the job-card readily available on final inspection!