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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 />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />(Please use a black or blue ink ball-point pen) <br />Project Address:\)zo w c!., (n*kr rlr <br />Permit Number:Itt <br />Property Owner:la\n O <br />Contractor:f {{h cc I \..1 <br />^( <br />License #t [0 )t-O7 | <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R3L4.1and 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 req u ired locations. <br />Aso,n boxes below must be checked: <br />E Carbon 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 />E Smoke 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 lwill retest the alarms per the <br />manufacturer's instructions. <br />(check onel cense d Contractor Property O er h^l <br />NOTE: Ihrs sef- certificdtion is only used for projects thot aflect the EXTERIOR of the structure. This <br />process is applicoble ONLY to projects where occess to the interior oI the dwelling by o Sonto Ano <br />lnspector is not required. <br />ISigndture Ddte <br />Have this completed form and th.n final inspection! <br />*-SNTA <br />NA-"ffiI <br />This document may be found ot,.. http://wvwv. sa nta-a na. orq/p ba/