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**SANIA <br />NA,Iffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />Project Address:Lqt (7 nl- t'l o(UAlJ to <br />oo lf,)b,oz- <br />Property Owner:lnn'. <br />IContractor:I LO {1,,(,icense #:o '(- <br />This document moy be lound ot...http://www. santa-ana.o rqlobal <br />(P/ease use a black or blue ink ball-point pen) <br />Permit Number: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 req uired locations. <br />f) eo,r, boxes below must be checked: <br />E[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 required in bedrooms with gas-fired <br />appl nces (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 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 twill retest the alarms per the <br />ma n ufacture r's instruct <br />lcheck onel tr Licensed Contractor Property Owner <br />NoTE: Ihis sef- certificotion is only used for projects thot ollect the ExTERtoR ol the structure. This <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by a Sonto Ano <br />lnspector is not required. <br />Signature:V Ddte:1-lc-(1 <br />Have this completed form and the job-card readily available on final inspectionl <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />NSP.O2 2013 CRC <br />tr