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,-rur frrt <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (Ml9) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />wwrv.santa-ana.oro t <br />Smoke & CO <br />Alarm Affidavit*,SANTA <br />NA,',t,ffii <br />INSP-02 2013 CRC <br />This document moy be lound dt...http://www. santa - ana.or ql obal <br />(Please use a black or blue ink ball-point pen) <br />State of California 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 requ ired locations. <br />Both boxes below must be checked: <br />Carbon monoxide alar Are insta lled outside o leeping area in the immediate vicinity of <br />eac h level of the dw elling arms are required in bedrooms with gas-fired <br />ces (t.e eater, cookto p, furnace) or a fireplace. <br />d Smoke a larms: Are installe oom used for slee ptn tn allway outside of a sleeping <br />and on e t e we tng <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 Flre 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 />ma nufacturer's i ruction <br />t6 <br />(check onel Licensed Contractor tr Pro perty Owner <br />NOTE: Ihrs sef-certificdtion is only used for projects thot affect the EXTERIOR of the strudure. This <br />process is applicable ONLY to projects where access to the interior of the dwelling by a Sdntd Ano <br />lnspector is not rcquired. <br />Project Address 2333 N. FLoUJER- <r. <br />Permit Number:1019 A963 <br />Property Owner:e.an 0e <br />Contractor:Ti\\ R '"Q\nq License #a77020 <br />eac <br />'each <br />Signotute:Hr+Ddte:Jo\y Lz 2 <br />Have this completed form and the job-card readily available on final inspection! <br />P+]