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*,SNTA <br />NA,Iffi <br />20 Civic Center Plaza Ross Annex <br />P.O. Box'1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNsP-02 2013 CRC <br />This document mdy be lound ot...http://www.santa-ana.o rqlobal <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address '\qpr g C,,,.sqoq (-r <br />Permit Number: <br />I \o'\qB\tl\ <br />Property Owner:E v rrs.5,,.1 9 \q -., a <br />Contractor:\.L {-nr Lo F\aAF\n License #: =6-l Za8 <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 R314.1and 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 />A eo,l, 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 />appliances (i.e, hot water heater, cooktop, furnace) or a fireplace. <br />EI Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeprng <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 />Signature:--.rt\ \sA Dote:b- \q-zo.r <br />(check onel EL tcense d Contractor tr Property Owner <br />\n*rc.. $n...r-a- <br />NOTE: Ihls sef-c ertificotion is only used for projects thot oflect the EXTERTOR ol the structute. This <br />process is opplicoble ONLY to ptojects where occess to the interiot ol the dwelling by d Sonta And <br />lnspector is not requircd. <br />Have this completed form and the job-card readily available on final inspection! <br />Planning & Building Agency