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*,,SANTA <br />NA <br />P[iTiI\C <br />$ BIITDIIC <br />ICt\CI <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-l9) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document mdy be found ot...http://www. santa-ana.orql obal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:rfzo /o S,t.//t,tz,,t <br />n/ o/,?.23 <br />Property Owner:2-i Ao*o-*,, <br />Contractor:a 6tz*z ?zae 2?.-License #, 6 alSC? <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <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 />Agortr boxes below must be checked: <br />(Carton monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedlboms 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 />ES"""f," 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 />ma n ufacturer's instructions <br />lcheck onel tr sed Contractor <br />NOTE: Ihfu sef-certilicotion is only used for projects thot olfect the EXTERIoR ol the structure. This <br />process is opplicoble ONLY to projects where occess to the interior ol the dwelling by o Sonta Ana <br />lnspedor is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Signdture:(V'Dote:-t ltat <br />Permit Number: <br />Property Owner <br />)