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;^,'SAN <br />NA-'ffi <br />L <br />'a.- '. g e u.' ,'7i ,g age. '.''., <br />20 Civic Cenier Pla:a Ross qnnex <br />P.O. Bo:, 1968 (rvl-i 9) <br />Santa Ana, Ca 92702 <br />(71a) 6,7.5800 <br />www,santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />'ts ( c-!.i,€, _,-,|qy )e iou c: aL.. <br />fplease use a black or biue ink ba)i-poinr pen) <br />hltp://wwur. sanla-ana.or q/pba/ <br />-- - e5-'-:AEl t L-ro,s St So..*o A"n QA <br />z-oh?foE <br />' '.i_l' 1,\, Ilc'O tq-n<o,.J <br />5un,u License *, $O lBul <br />SLate ol California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and R315.2 states in part that existing dwellings be <br />"reirofitted v.rith smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R3153 define <br />the req u ired locatio ns. <br />f, l e",rl boxes below must be checked: <br />El Carbon monoxide alarms: Are installed outsicie of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling, Alarms are recommended in bedrooms with gas-fired <br />appliances (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 asleeping <br />room, and on each levelof the dwelling. <br />Retrofitted detectors may be ba tte ry-o pe rated for buildinBs 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 (5f M). aattery 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 thegoverning <br />Codes and have been tested to be functional. <br />\check one)tr Licensed Contracto r ,( Property owner <br />iIOTE: ih6 s ef-c ertiJication is only used for projects thot alfect the EXTERIOR of the structure. This <br />orocess is opplicoble ONLY ta projects where access to the interior of the dwelling by o Sonta Ana <br />irspec:or is not required, <br />-lave this completed form and the job-card readily available on final inspection! <br />4 Dote:,1" s- t7Signatur <br />to tolYt e7