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*-SNTA <br />NA-"'ffi <br />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, CA92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />rNsP-02 2013 CRC <br />This document moy be found at..,http://www. sa nta-a na.or qlobal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:a <br />Permit Number: <br />Property Owner:SuAn Ere,t I <br />Cowl License #:oo.{j <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u 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 required locations. <br />Aeo,t boxes below must be checked: <br />p 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 I will retest the alarms per the <br />ma n ufactu rer's instructions. <br />(check onel icensed Contracto r P roperty Owner <br />NOTE: Ihis sef- certification is only used for projects that alfect the EXIERlrc.R of the structure. This <br />process is applicable ONLY to projects where occess to the interior ol the dwelling by o Sonto Ano <br />lnspector is not required. <br />Signoture: <br />I <br />Have this completed form and the job-card readily available on final inspection! <br />?5lt YL, <br />/O l7'['1t1., <br />Contractor: <br />\-.._