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*,,SANTA <br />NA-"'ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.'19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www,santa.ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />tNSP-o2 2013 CRC <br />This document mqy be found ot... http://!U4ryv. Santa-a na.ofq/pba/ <br />(Please use a black or blue ink ha -point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.L and 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 />f\aotn uo*", below must be checked:(r <br />7Q CarUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />1 bddrooms 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 />p Smoke alarms: Are instailed in each room used for sleeping, in each hallway outside of a sieeping <br />/dom, 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. lfurther 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 />lcheck onel tr Licensed Contractor tr Proper Owner <br />NOTE: Ihis sef-certificotion is only used lor projects that atlect the EXTERIOR ol the structure. This <br />process is applicdble ONLY to projects where dccess to the interior of the dwelling by a Santa Ano <br />lnspector is not required. <br />Project Address:lA2l W MuLn,-1)r .iantr"An, (/lQltrtl <br />Permit Number:l0t1 ttl40-) <br />Contractor:4,n,.th wut Jun \ol n r License #, lL,(,4 t A 1, L - I 0 <br />Signoture:1o rlc-Dote t6/ <br />Have this completed form and the job-card readily available on final inspection! <br />Property Owner: