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*,SNTA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm AffidavitP.O. Bor 1988 (M-'19) <br />Saflta Ana, CA 92702 <br />(714)647.5800 <br />w.^/.,/ santa-ana orq <br />tNsP"o2 201 :] CRC <br />fhis document mqy be found ot,h ttp://\/11,v,/,/. santa -a na ofdpbai <br />(Please use a black or blue ink ball-point pen) <br />j? Z-o 5. BEArz uFrtr G- <br />Permit Number:\o t 3L .1" b3 <br />Property Owner:B A.-ts\ <br />Contractor:f\ cos-r A l{U AC <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 locatjons. <br />A eoth 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 buildlngs 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 pro.ject. 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 />manufacturer's instructions. <br />L rce n se d Contractor tr Property ner <br />NOTE: Ihls sef-certification is only used fot projects thdt offect the EXTERIOR of the stucture. This <br />process is opplicoble ONLY to projects where dccess to the interior of the dwelling by o Santd Ana <br />lnspector is not required. <br />-R r'c-a(<4Signoture Date:Zt \8Iocl <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: <br />License#: tS.1 oB5 <br />(check one)