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*-sAll'[A <br />NAffi <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 sante-ana.orc <br />Smoke & CO <br />Alarm Affidavit <br />INSP{2 2!T ] CRC <br />fhis document moy be found ot... httO:i,lnv',v Santa-ana.Orqi pbai <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:iot?W, V,/ttsttt<i AVc S4tuTA n N/1 etl L/)7cty.31,tI <br />Permit N umber:,/o't?.3.\f 4 <br />Property Owner: :5I,.]/'f!/lvLt dt:/,ttli (?Ati rt,-L <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 required locations. <br />A so,h boxes below must be checked: <br />El 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. Aiarms are required 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 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 naust be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. I further certjfy <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 />man ufacturer's in s t rr.,ct io n-s. <br />Signdtrre:r/sc, 7 <br />lcheck onel Licen sed Con tractor E P roperty Owner <br />NOTE: fhiJ sef-c ertification is only used for projects thdt affect the EXTERIOR of the structure. This <br />process is applicoble ONLY to prcjects where occess to the interior ol the dwelling by o Sontd Ano <br />lnspector is not required. <br />_-!-Dot?:o(It <br />Have this completed form and the job-card readily available on final inspectionl <br />JZ