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*,,SNTA <br />NA.ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box ,l988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />ww.rv sJntJ-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNS2,0:20r3 CRC <br />fhis document mqy be found at... http:/;'/1^,l', sa nta-a na.o rq,'pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address: lt Zl (4cst /g! Sr S rtne- An- <br />Permit Number:ZolLJtl ro <br />Property Owner:Ailllrrr.wy Garo /.,,. <br />Contractor:-S ul I t V-t* jol.r ?o,u"z- License #: q1o - (31of 7 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ing s. <br />California Residentlal Code (CRC) Sect,on 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 requ ired locations. <br />A eo,i, boxes below must be checked: <br />/C^rbon monoxide alarms: Are installed outsrde of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dweiling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />FsmoXealarms: Are installed in each room used for sleeping, in each haltway outside of a sleeping'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 appro'red <br />by the State Fire Marshall {SFM). Battery life must be 10 year's. <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 governlng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />Signature:Dote 1 ? <br />\check o Licen se d Con tractor Prope rty Owner <br />NOTE: fhi5 sef-c ertificotion is only used lor proiects that offect the EXTERIOR ol the structwe. This <br />process is applicable ONLY to projects where occess to the interior ol the dwelling by a Sdnto Ano <br />lnspector is not requited. <br />Have this completed form and the job-card readily available on final inspectionl <br />ma n ufactu re r's instructions <br />tr