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fl/rtL <br />Planning & B <br />20 Civic Center Pl <br />uilding Agency <br />aza Ross Annex Smoke & CO <br />Alarm AffidavitP.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714)647.s800 <br />w,'l.,! santa-ana or"r <br />This document moy be found at... h ttp:/iwl,v.rv <br />1NSP,O2 2013 CRC <br />santa-ana.oro/pba/ <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 />bu ildings, <br />california Residentral Code (cRC) section R314.1and R3i"5.2 states in part that existang dwellings be"retrofitted with smoke alarms and carbon monoxide alarms. cRC section R314.3 and R314.3.3 definethe required locations. <br />A aoah boxes below must be checked: <br />E rb on monoxide alarms: A installed outside of each sleeping area in the immediate vicinity of <br />f the dwelling. Alarms are required in bedrooms with gas_fired <br />ooktop, furnace) or a fireplace. <br />bed roo VE lo <br />appliances (i.e, hot water heater, c <br />moke alarms:nstalled in each room used for sleeping, in each hallway outside of a sleeping <br />I of the dwelling.roo ach I <br />Retrofitted detectors may be battery-operated for buirdings where no interior arterations areperformed combination smoke/co alarms must comply with all applicable standards and be approvedby 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 certifythat smoke alarms and carbon monoxide alarms have been installed in com pliance with the govern ingCodes and have been tested to be functional. l, also, hereb y certify that lwill retest the alarms per thema n ufacturer's i tructions <br />trL rcen Contractor Pro perty Owner <br />NorE: rh,s sef-c ertificdtion is onry used for projects thdt dflect the ExrERtoR of the structurc. Thisprocess is applicable ONLY to proiects where occess to the interior ol the dwetting by d Santa Analnspector is not requhed, <br />*,,SNTA <br />NA#iffi <br />Project Address:t45 t8 ork tEL <br />Permit Number:ol 1 L{.1 <br />Property Owner I1 <br />Contractor:/-License #:O <br />Signoture:Date: <br />Have this completed form and the job-card readiry avairabre on finar inspection! <br />(check onel