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Planning & Building A,gency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.l9) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www,santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP-02 2013 CRC <br />This document mqy be lound ot,.,htto://wr,rrw.santa-ana o rqlpbal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:ll0l W?ine St Santa rino (A 92 10t <br />Permit N umber:0t tonoo+4 o ; E* fuYtgtUl <br />Property Owner:)banq <br />5^,lhttlot 51,* trt lr,-License *, 100/til V; C-tO <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 requ ired locations. <br />4\ ao,!' boxes below must be checked:L <br />JAI 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 />! Smote 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 (SFlvl). Battery life must be L0 years, <br />I hereby certify that I am the contractor or the property owner of the above project. lfurther 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 one)icensed ntractor tr Property wner <br />NOTE: fhrs sef-ce ttilication is only used for projects that dffect the EXTERTOR of the structure. This <br />process is dpplicdble ONLY to ptojects where access to the interior of the dwelling by a Santd Ano <br />lnspectot is not required. <br />Signqture:,rl A- <br />Have this completed form and the job-card readily available on final inspection! <br />*,JANTA <br />NA,'trffi <br />Contractor: <br />Dote: