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This document moy be lound dt...http //www.santa-ana.orcl obal <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:A'+18 uJ, L-f U6K^lr rll/D :irt^n6 Ar.rA <br />Permit Number:l0lc1i,r9to <br />Property Owner:LUZ nhuft V\rztU)eZ <br />Contractor:62.,<rtEYP JY|-AL License #:761109 <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 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 />Aeo,ir boxes below must be checked: <br />A 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 gas-fired <br />applances (i.e. hot water heater, cooktop, furnace) or a fireplace.,// <br />4S^olrealarms: 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 Boverning <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />man ufacturer's instructions. \ <br />lcheck onel icensed Contractor Property Owner <br />NOTE: Ihis sell-certificotion is only used lor projeds that aflect the EXTERIOR ol the strudure. This <br />process is applicable ONLY to projects wherc dccess to the interiot of the dwelling by a Santo Ana <br />lnspedor is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Signdture:{ 4et Dote d tb I t1 <br />,^-SANTA <br />NAqil} <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 />Alarm Affidavit <br />rNSP-02 2013 CRC <br />tr <br />I