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**SNTA <br />NA <br />Itr\lN <br />lSuur\-G <br />lct\11' <br />Planning & Building Agency <br />20 Civic Cente. Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />Smoke & CO <br />Alarm Affidavit <br />an a, orq <br />Project Address:I9m =, PvpLDrL+ kt-, <br />Permit Number:lollzq rut () <br />Property Owner:4,4 r/a Lna y'ttsh llo <br />Contractor:Tnrtnik) Fnzrtu License #: <br />rNSP,02 2013 CRC <br />This document mdy be lound ot...htto://www santa-a na.oro/oba/ <br />(Please use a black or blue ink ball-poinl pen) <br />State of California requires that smoke and ca on monoxide (CO) alarms are installed in residentialI <br />bu 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 />/) ao,n boxes below must be checked: <br />p 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 />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Et'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). 8attery 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 certlfy that I will retest the alarms per the <br />manufacturer's instructions <br />(check onel Licensed Contractor Property Owne <br />NOTE: Ihis sef-c ertification is only used for projects that offect the EXTERTOR of the structure. This <br />prccess is dpplicdble ONLY to ptojects where occess to the interior of the dwelling by o Sonto Ano <br />lnspedor is not required, <br />Have this completed form and the job-card readily availa6le on final inspection! <br />Signdture Doy:U <br />I <br />I <br />tl 0 'l