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*-SNTA <br />ANA-"'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 />\./\.r,,/.s anta -a n Lo ral <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document moy be found at,..://r,nvyr.santa-an <br />(Please use a black or blue ink hall-point pen) <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 required locations. <br />{ }tBoth boxes betow must be checked:I <br />d CarUon monoxide atarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrogrrns and also on each levelof the dwelling. Alarms are required in bedrooms with gas-fired <br />appJi6nces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />d 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 tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />ma nufactu rer's instructions. <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: This self-certificotion is only used for projects thot offect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by o Santo Ana <br />lnspector is not required. <br />Project Address:2 tt b S. Ocarrec U/e , <br />Permit Number:lor I o) lqt \ <br />Property Owner:T; {tan. <br />Contractor:License #: (;l{qo? <br />Signoture:r Dote 2. q ,zo ?!) <br />Have this completed form and the job-card readily available on final inspection!