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rNsP-02 2013 CRC <br />f his document moy be lound at...http:i/www.santa-ana.o rq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:86L 18'oe + . 'z^..+ + <br />Permit Number: <br />Property Owner:(3.,.LA'tt..C,\oc-t- \ *'ses\*^o-Js <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (CRC) Section R314.1 and 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 so,rr 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 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 I will retest the alarms per the <br />manufacturer's instructions. <br />(check onel Licen sed Contractor Property Owner <br />NOTE: fhis serf- certificdtion is only used for projects thot olfect the EXTERIOR ol the structure. This <br />process is opplicable ONLY to projects where occess to the interior ol the dwelling by a Sonto Ano <br />lnspectot is not tequired. <br />Signoture:Ddte:t-lzlzovl <br />*,SANIA <br />NA,tffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />www. santa-an a.orq <br />Smoke & CO <br />Alarm Affidavit <br />D <br />Have this completed form and the job-card readily available on final inspection!