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,-SNTA <br />NAJ[iilffi <br />e <br />ArE-rl.lbo.n-r,l - <br />Planning & Building Agency <br />20 Civic Center Plaza Boss Anner Smoke & CO <br />Alarm Affidavit <br />This document moy be found at...http J,iwww. santa-ana.o rq/pba./ <br />(please u* a black or blue ink ba -point pen) <br />Proiect Address:lS33 ulrJ /Ail !.".f <br />Permil Number:/0197b//- <br />Property Owner:-f hanl^ Da^a <br />Contractor:SVJnr,^ %\:1,^o I ucense *, ?10=zl <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />Califomia 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 R315.3 define <br />the required locations. <br />A *an boxes below must be checked: <br />EI C"Aon 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cookop, furnace) or a fireplace. <br />El'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 />ms and ca rbon monoxide alar ve been installed in compliance with the governingthat smoke alar <br />Codes and have ested ton <br />(check onel q Licensed contractor Property Owner <br />NOfEt This selr-certificotion is only used for projects thot ofied the EXTERIOR oI the structure. This , <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by o Sonto Ana <br />lnspectot is not rcquired. <br />D(,te "7-/s- tlV <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M-19) <br />santa Ana, cA 92702 <br />(714) 647-s800 <br />www.san ta-a na. o rq <br />Signoture: <br />I <br />I