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-,-SANTA <br />NA <br />Pt{N\0 <br />InttD[[ <br />rmfi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(71lt) M7-5800 <br />www.santa-ana,orq <br />Smoke & CO <br />Alarm Affidavit <br />tNSP-02 2013 CRC <br />This document moy be lound ot...htt //www, santa-ana.o bal <br />(Please use a black or blue ink ba -point pen) <br />License #:b 5 <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 R314.1 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 requ ired locations. <br />A *,n oor"s below must be checked: <br />E Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwellinB. 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 />manufacturer's instructions. <br />'-1 <br />lcheck onel nsed ContractorLi roperty ne <br />%\w- c,crrdevtn\ ..,-\ <br />Permit Number:\o\ q3z\5 <br />Property Owner:Tnrn hvuKewla\\ <br />Contractor:s"\t ff,."t_,."^ I 1\65 b <br />/Dote /-4,*53,22;Signoture <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: <br />1 <br />E, <br />NOTE: Ihis serf-certificotion is only used lor projeas thot olled the EXrERIOR oI the structurc. This <br />process is applicoble ONLY to projects where occess to the inte ot oI the dwelling by o Sonto Ano <br />lnspectot is not rcquhed.