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*-SNTA <br />NA,Iffi <br />Planning & Building Agency <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 />tNSP-02 2013 CRC <br />This document moy be lound at..http://www.santa-ana.o ralobal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2ftt s uoJ,lo" 4 ql <br />Permit Number:lclls /c7 <br />Property Owner:D G uo/ <br />Contractor: <br />i <br />License # <br />(check onel tr License ontractor X Property Owner <br />NoTE: Ihr's sef-c ertilicotion is only used lor projects thot offect the ExTERtoR ol the structure. This <br />process is opplicable ONLY to projects where access to the interior oI the dwelling by o Santa Ano <br />lnspedor is not required. <br />I D,- B /,1Signature:Dote:,i,/76 /or, <br />Have this completed form and the job-card readily available on final inspection! <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 req uired locations. <br />A aoth 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 />SSmote 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 />manufacturer's instructions.