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-,-SANTA <br />NA <br />lLr\\l\c <br />n8u.fl\[ <br />lct\fl <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.olo <br />Smoke & CO <br />Alarm Affidavit <br />fhis document may be lound ot...htto://www.san ta-ana.oroioba/ <br />(please use a black or blue ink ball-point pen) <br />Proiect Address:L,2-l 3 l.crwr ov1 cr D r t 'I g <br />Io \ c3 350 <br />Property Owner:)<r-so f4cratf <br />Contractor:License #: <br />Permit Number: <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 R31.5.2 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 />Aro,n 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. Alarms are recommended 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 owrrer 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. <br />(check onel tr Licensed Contractor Property Owner <br />NOTE: Ihis sef-ce rtilicdtion is only used lor prcjects that olfect the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projeds where occess to the interior ol the dwelling by o Santo And <br />lnspector is not required. <br />Ddte 6-z+-za+ <br />Have this completed lorm and the iob-card readily available on final inspection! <br />I <br />Signoture: <br />^u/L