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*,,SANTA <br />NA <br />PL,I,\\IIC <br />& BIILDI\C <br />$Nl <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />www,santa-ana,orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />fhis document moy be found at...htto:/iwww . santa-ana.orq/oba/ <br />(Please use a black ot blue ink ball-point pen) <br />ma n ufactu rer's instructi s <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: Ihrs se/r-certificdtion is only used for projeds that olfed the EXTERIOR of the strudure. This <br />process is opplicable ONLY to projects where occess to the interiot oI the dwelling by a Santd Ano <br />tnspedor is not requhed. <br />Project Address:$oo =, s.r\\rrrnrz \)fvr^r ? <br />Permit Number:\orq6g1t+ <br />Property Owner:f2 <br />Contractor:6re l,/-^-Azig 6frLicense #: <br />Signdture:Ddte:Q"- R- l,q <br />Have this completed form and the job-card readily available on final inspection! <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 R314.3.3 define <br />the requ ired locations. <br />f\aott, 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 lwill retest the alarms per the <br />tr tr