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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />wYvw.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP,O2 2013 CRC <br />This document moy be found at.,,htto://www.santa-ana.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:Z3ql l\ar< Laoe 4ar*a pt,n^ C* q?aoA <br />Permit Number:+ \c\q;c$a <br />Property Owner:{Jasr? <br />Contractor:IUA 9\r-License#: lO\\567- <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California Residential Code (CRC) Section R3l.4.1and 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 />f,\ sottr boxes below must be checked: <br />E C"rbon 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 />S Srnof" alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />ioom, 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 />ma n ufacture/ s instructions. <br />lcheck onel Lice n se tr Pro rty ner <br />NOTE: Ihis selr-certilication is only used for prcjects thot olfed the EXTERIOR ol the strudure. This <br />process is opplicable ONLY to proieds where occess to the intefior of the dwelling by d Sonto Ano <br />lnspedor is not required. <br />Signoture:.V Ddte:crt/rslrg <br />,,--SANTA <br />NAJIHI <br />/---=- <br />Have this completed form and the job-card readily available on final inspection!