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*,SNTA <br />NAJIffi <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 />Project Address I b\z +h <br />Permit Number: <br />b-(( <br />Contractor:License #: <br />this document moy be lound ot... htto.1 4 !ryw. sa nta-ana.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />L <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu 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 requ ired locations. <br />f\ aoth boxes below must be checked; <br />fAl 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 />hJ- <br />${ Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />lodm, 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 functlonal. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instructions. <br />Signature: <br />0 <br />BI <br />lcheck onel tr Licensed Con tractor tr Property Owner <br />NOTE: Ihis sef-c ertificdtion is only used lor projects thot dlfect the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projeds where access to the interiot ol the dwelling by d Sonto Ano <br />lnspector is not requited. <br />Dote:1-cLv a 1-a) <br />Have this completed form and the job-card readily available on final inspection! <br />NSP.02 2013 CRC <br />Property Owner: