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*-SNIA <br />. .NA,hHI <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-s800 <br />www.santa-a na.orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP-02 2013 CRC <br />This document moy be lound ot..http://www.sa nta-ana.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:Lb 7d 8.Tt7\etntn+ 5+ <br />2Ot1o57J 140134344. <br />Property Owner: 'lrqatult)pe Sqlinq5 <br />Contractor:J-uan Jutq.License *: floo!0 f 1. <br />I hereby certify that I am the contractor or the property owner of the above project. I further certify <br />that smoke dlarmi 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 />man ufactu re r's instr ns. <br />lcheck Licensed Contractor tr Prope Owner <br />NOTE: Ihrs sef-c ertification is only used for projects thot aflect the EXTERIOR ol the structure. This <br />process is applicoble ONLY to projects where access to the interior oI the dwelling by a Sonta Ano <br />lnspector is not required, <br />Signature:Date:rlq/uL0 <br />Have this completed form and the job-card readily available on final inspection! <br />Permit Number: <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 />4\ eoth boxes below must be checked: <br />EfCarbon 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 />applpnces (i.e. hot water heater, cooktop, furnace) or a fireplace, <br />E 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 interlor 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.