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P.O. Box 1988 (M-'19) <br />Santa Ana. CA 92702 <br />(714) 647.5800 <br />w'r/rtv santa-ana orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP-02 20r3 CRC <br />This document mqy be found ot.http:ii \,^ ,^ /,/. santa-a na-OfSlpOa/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2lt1 -f. friDvrEvt /x; <br />Permit Number:l0s%41'r <br />Property Owner:€^A,a, ///// <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide {CO) alarms are installed in residential <br />b u ild ing s. <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 />fl eo.n boxes below must be checked: <br />d Carionmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinrty of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />applrances (r.e. hot water heater, cooktop, furnace) or a fireplace. <br />d Srnot " alarms: Are installed in each room used tor sleeping, in each hallway outslde ot 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 1.0 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 />man ufactu re r's instructions. <br />lcheck one)Lic e nse d Cont rac tor Property Owner <br />NOTE: Ihis sef-certification is only used fot projects thdt offect the EXTERIOR of the structure. This <br />process is opplicdble ONLY to projects where occess to the interior ol the dwelling by d Santd Ana <br />lnspector is not required. <br />Signature:,--/-/.ttrZ-r'a- <br />Dote:1-lr-lg <br />Have this completed form and the job-card readily available on final inspection! <br />*,SNTA <br />NAqffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex