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*,SNIA <br />NA.ffi <br />Plan ning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647.s800 <br />wrl ,v santa-ana.otc <br />Smoke & CO <br />Alarm Affidavit <br />rNsP-o2 2Cr3 CRC <br />This document moy be found ot..h tto 1 ',^r,v'l santa-ana.orqi Dba <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address: A N <br />Permit N umber:GO <br />Property Owner:claf ,t'.IcL-- <br />Contractor:License # <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Sectjon R314.1 and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R31.4.3 and R314.3.3 define <br />the required Ioca tions. <br />f\eo,h boxes below must be checked: <br />EICarbon 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 />fiSmot<e 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 alt applicable standards and be approved <br />by the State Fire Marshall (sFM), Battery life rnust be 10 years. <br />I here by certify that I am the contractor or the prooerty owner of the above project. I further certify <br />th at smoke a la rms an cat de alarms have been installed in compliance with the governing <br />Codes and have bee <br />0 <br />tional. l, also, hereby certlfy that I will retest the alarms per the <br />manufacturer's instr <br />Signatute:Dot <br />lcheck onel en5e d Con tractor P roperty Owner <br />NOTE: fhis seu-certificdtion is only used lor prcjects thdt offect the EXTERIOR ol the structurc. This <br />process is applicable ONLY to projects where access to the intetiot of the dwelling by a Sonto And <br />lnspector is not required. <br />e fun <br />no <br />Have this completed form and the job-card readily available on final inspection! <br />il