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*,'SAI\ITA <br />NAqffi <br />Planning & Building Agency <br />20 Civrc Ccnter Plaza Ros' ,inex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />wwr. sante-ana, crq <br />Smoke & CC <br />Ir Alarm Affidavit <br />-t <br />t_ <br />rNSP-02 201: CRC <br />This document mqy be found ot...htto ://'r1/'Av. santa-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />2io(An_Project Address <br />\ 0t( ht-r't <br />Zisi< aJan-e- <br />Contractor:|l-D il.rr, 4r'c License #: 7o&?)z <br />State of California requirds that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California ResidentialCode (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 />f\ eo,h boxes below must be checked: <br />f Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />ledrooms 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 />/ S^oXealarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />foom, 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 propeny 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 />ma nufactu rer's instructions <br />lcheck one tr Licensed Contractor Pro perty Owner <br />NOTE: Ihis sef-certificotion is only used for projects that dffect the EXTERIoR of the structure. This <br />process is opplicoble ONLY to proieds where dccess to the interior ol the dwelling by o Sdnto Ano <br />lntpector is not required. <br />Signoturc:/D,",lb_6 - \-l <br />Have this completed form and the job-card readily available on final inspection! <br />Permit Number: <br />Property Owner: <br />I