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*,,SANTA <br />NA,ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Clvic Center Plaza Ross Anner <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />w'r'&.saal3-rna orq <br />rNsP,02 2013 CRC <br />fhis document mdy be Jound ot...htto./ .,r,'r',v.santa-ana.ore oba <br />(Please use a black or blue ink ball-point pen) <br />Project Address:( <br />Permit Number:t0t 0ll <br />Property Owner:c t.- <br />Contractor:License #: <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 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 />,A so,tr boxes below must be checked: <br />f, CarUon 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 gas-fired <br />(prpliances (i.e. hot water heater, cooktop, furnace) or a fireplace_ <br />fi Smot 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. 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 t functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's i ru <br />),o <br />lcheck onel icensed Contracto r Pr ert Owner <br />NOTE: This se ff-certificotion is only used for prcjects that offect the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwetting by o Sonto Ana <br />lnspector is not required. <br />Signoture:I Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I I