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#$A}TH <br />NA,ffi <br />T <br />Planning & Building Agency <br />20 Civic Center Plaza RosS Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />,{'/v,r'/. sln ta-an a. orq <br />flsP-02 2013 cRC <br />This document moy be found at...anta-ana.orq,/oba/h ttc i i',v,,',',v s <br />(Please use a black or blue ink ball-point pen) <br />Project Address: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />Californla Residential Code (CRC) Section R314.1 and 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 />f\ eo,h boxes betow must be checked: <br />Ca rbon m noxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />ooms and <br />p ances (i. e. hot water heater, cooktop, furnace) or a fireplace <br />Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />om, and on each level of the dwelling <br />Retrofitted detectors may be battery-ope rated 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 f nctional. l, also, hereby certify that I will retest the alarms per the <br />man ufacturer's instruct <br />b <br />Lic Cont ractor tr Property Owner <br />NoTE: fhts sef-c ertification is only used for projects thot offect the EXTERI?R of the structure. This <br />process is opplicable ONLY to projects where occess to the inte or ol the dwelling by a Sonto Ano <br />lnspector is not tequired. <br />R*zs furtJra-e,L42 <br />Permit Number: <br />Contractor:i%'m'License o67ZZ'a; <br />Signoture:Ddte:/t / <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />lso on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />lcheck onel <br />Property Owner:6aJ4a* <br />z