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Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />santa Ana, cA 92702 <br />(714) 647.5800 <br />www.santa-ana.orq <br />NSP-02 2013 CRC <br />This document mdy be Jound ot...http ://wvwv. santa-ana. oro/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:/(")-? N ,/]ua/o^t ,3oala.--,ina .t <br />Permit Number:to/gDBl <br />Property Owner Eo-r*Fro-usea) (h/reion <br />Contractor:/1im*,r,n z 9.uu fif,Yit""',,-*' ?lst t9 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu 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 requ ired locations. <br />f|eoah boxes below must be checked: <br />Fc"rUon 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 />psmot<e 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 ufactu rer's instructions. <br />(check onel Licen sed C ontractor Property Ow er <br />NOTE: Ihis sef-certification is only used for projects that offect the EXTERIOR ol the strudure. This <br />process is opplicable ONLY to proieds where occess to the interior of the dwelling by a Sonta Ana <br />lnspector is not required. <br />Signdt ure:Dote:ta -3t /t( <br />Have this completed form and the job-card readily available on final inspection! <br />**SNTA <br />NA,',rffit <br />tr