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*"SNTA <br />NA.ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Anner <br />P,O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-sA00 <br />w,/|.r.santa-an 3 orq <br />Smoke & CO <br />Alarm Affidavit <br />[']sP-02 20 r3 cRC <br />This document may be lound ot.h ltP :/ir,w,n v. sa n te -a na. o rq,'0ba./ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:ZozB E L.)Ec-rr AcToN Au f <br />7o16a367 <br />Property Owner:ALrn € f4c(01 <br />Contractor:A0vAnre0 I ,vrlr,r,-- r,tar6 Lice nse #:1\++61 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u 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 required locations. <br />f,\aott, boxes below must be checked: <br />EKrbon 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 />hoke 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 />(check onel tr Licen se d Con ractor Property Owner <br />NOTE: Ihis sef- certificotion is only used lor projects thot dffect the EXTERIOR of the structure. This <br />process is opplicoble ONLY to projects where occess to the interior ol the dwelling by o Sonto And <br />lnspector is not rcquired, <br />Have this completed form and the job-card readily available on final inspection! <br />S ig notur e:6&-;^.- fuaA"rr-Dote: <br />c/ /,1 )!t <br />] Permit Number:I <br />I <br />I <br />I