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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 />w,,vw santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:t3 S Tf.6r <br />Permit Number:Lot 66316 <br />Property Owner: <br />Contractor:7//(License *,837657ALU5Nfr^/ <br />rNsP-02 2013 CRC <br />This document mdy be lound ot...htto://www. santa-a na.orq/pba/ <br />(Prease use a black or blue ink ball-point pen) <br />State of Callfornia requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 />Aeoah boxes below must be checked: <br />MCrrbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. AIarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />El 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 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 to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instructions. <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: Ihrs sef-certificotion is only used for projects that dflect the EXTERIOR oI the strudute. This <br />process is opplicoble ONLY to projeds wherc occess to the interior of the dwelling by d Sontr, And <br />lnspectot is not required. <br />Signdture:w v-23- /6 <br />Have this completed form and the job-card readily available on final inspection! <br />*-SANTA <br />NAJ}ffi <br />tr <br />Dote: