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*,SNTA <br />NA,Tffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />INSP-02 2013 CRC <br />fhis document moy be lound ot... http://www. satla-ana.org/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2233 [l ^\\o I.., 9+ e^^1. A^^-aA <br />Permit Number:lo lq, 1,1 oJ4 t <br />Property Owner:e D cann4o <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ing s. <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 />'.\ <br />h boxes below must be checked <br />Carbon monoxide alarms: Are installed outsrde 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 />applian 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 lwill retest the alarms per the <br />ma n ufactu rer's instru tions <br />lcheck onel Licensed Contractor tr P roperty Owner <br />NOTE: Ihis sef-c ertification is only used lor projects thot olfect the ErTERIOR of the structure. This <br />process is applicdble ONLY to projects whete dccess to the interiot ol the dwelling by o Santa And <br />lnspector is not requircd. <br />Signoture:/-#Dote:6-6 /7 <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />P.O. Box l988 {M.19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.oro <br />I <br />I