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*-SANTA <br />NAqffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />1NSP,02 2013 CRC <br />This document moy be lound qt-..htto ://www. sa nta-ana. orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />A D3 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <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 requ ired locations. <br />A ro,n boxes below must be checked: <br />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 />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 pro.iect. 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 instructions b-4-t <br />Signotute: <br />lcheck one\tr Licensed Contracto r Property O\ivner <br />NOTE: Ihis sef-c ertificdtion is only used for proiects thot affed the EXTERIOR of the strudure. This <br />process is opplicoble ONLY to projects where occess to the interior ol the dwelling by o Sontd Ano <br />lnspector is not required. <br />Project Address: <br />6IPermit Number: <br />Property Owner: <br />Contractor: <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www.santa-ana.olq <br />I <br />l-, ),)t x-n) {/. <br />License #: <br />Dote: