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-,.-SANTA <br />ANAJII}ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />www.santa-ana.oro <br />Smoke & CO <br />Alarm Affidavit <br />I <br />This document moy be found at... http://www.santa-ana.oro/pba/ <br />(please use a black or blue ink ball-point pen) <br />Project Address:l2;}l 0- Daisv Ave <br />Permit Number:101103558 <br />Property Owner:Sleve Ttaseco. <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 R315.3 define <br />the required locations. <br />nBoth boxes below must be checked: <br />ICarUon monoxide atarms: 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 />E[Smot<e 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 be functio <br />lcheck onel ctor Pro Owner <br />NOTE: This seff-certificotion is only used for projects thot offect the EXTERIOR of the strudure. This <br />process is opplicoble ONLY to projects where dccess to the interior of the dwelling by a Santo Ano <br />lnspedor is not required. <br />Have this completed form and the iob-card readily available on final inspection! <br />Lice <br />Signoture:/)Date: