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Planning & Building Agency <br />20 Civic Center PIaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />tNSP-02 2013 CRC <br />This document may be lound at...htto.i/rm,wv. sa nta-a n a.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:Ltztt N, 6rc-e--.,^-alt </ . <br />Permit Number:tDlqltqq <br />Property Owner:6"'"- Llo.., r. <br />Contractor:G L4a .)thYl License *, n\ 1L'7 1 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild in gs. <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 req u ired locations. <br />. fl ro,n boxes betow 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 gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />'ElSmoke 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 />m an ufactu rer's instructions <br />(check onel cense ontractor tr Property Owner <br />NOTE: This self-certification is only used lor projects thdt offect the EXTERIOR of the structure. This <br />process is applicahle ONLY to projects where occess to the interior olthe dwelling by o Sonto Ano <br />lnspector is not required. <br />iI ?Ddte:z-- <br />**SNTA <br />N4,"ffi <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />www.santa-an a.orq <br />tr <br />Signoture: I <br />I <br />Have this completed form and the job-card readily available on final inspection!