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*,SANTA <br />NA <br />PLI\ITiG <br />&[uDnG <br />Ifi\CI <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <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.orq <br />tNSP-02 2013 CRC <br />This document mdy be found ot...htto://www.san la-ana.orolobal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:4zl Alo;,;l A.t <br />Permit Number:/olloLYSL <br />Property Owner: <br />Contractor:Crol rool 49-v>t -z License #: c-37 7l o / /? <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R3l.4.1and 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 />A eo,h boxes below must be checked: <br />dC^raonmonoxide 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 />EKmok" 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 />manufacturer's instructions. <br />lcheck onel E-.'Licensed Contractor tr Property Owner <br />NOTE: Ihis sef-certificotion is only used lor projects that ollect the ErTERIOR of the structure. This <br />process is applicoble ONLY to projects where occess to the interior oI the dwelling by o Sontd And <br />lnspector is not required. <br />Signature:Date 2-{'zOE\/ L/ <br />Have this completed form and the job-card readily available on final inspection!