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*,,SANTA <br />NA <br />PII\\NC <br />t lul-0nG <br />\CilII <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.sanla"ana.or0 <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:l0-t-- O. +-QavtlwV- vl-t <br />Permit Number:ro((o"t--Kq"1 I <br />Property Owner: <br />Contractorr &C.Tts^ {L*U License *: lAz-fi|) <br />This document moy be fuund ot.,.htto://www nta-ana.oro/pba/S <br />(please use a black or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 R315.3 define <br />the required locations. <br />A sott boxes below must be checked: <br />X 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />flsmok" "l"r.s: 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. <br />lcheck onel tr Licensed Contractor A Property Owner <br />NOTE: IDis sell-certificdtion is only used for projects thot offect the EXTERIOR of the strudure. This <br />process is applicoble ONLY to ptojeds where occess to the inte ot oI the dwelling by a Sonta Ana <br />lnspedor is not required. <br />Signoture:Date l-\t-?-D <br />Have this completed lorm and the job-card readily available on final inspection! <br />LA2