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*,,SANTA <br />NA <br />ll.!,\]llc <br />& BI II,DI\C <br />lct\o <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />tNSP-02 2013 CRC <br />This document mdy be lound at...http://www. santa-ana.orq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:/227 N. 5 Purza e^t sr Slnza .w4, c4 <br />Permit Number:za/Lzqr3/ /oDZr,Ly <br />Property Owner:jrt/ 2/ ZZ/ 7rtft-c- <br />/U fL /z/S77ucfp- / ,HL License #: fi? lVg <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 required locatrons. <br />f\ eo,ir 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 />E] Smoke 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 I will retest the alarms per the <br />manufacturer's instructions. <br />Signoture:,12/, /t/25a.Dote:zo,/zz/e* <br />lcheck onel {Licensed Contractor Property Owner <br />NOTE: Ihis serf-c ertilicotion is only used fot prcjects thot alfect the ErTERIOR oI the strudure. This <br />process is opplicoble ONLY to projects where access to the interior oI the dwelling by d Sontd Ano <br />lnspectot is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />tr <br />Contractor: