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*O'SNTA <br />NA,'ffi! <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm AffidavitP.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />a -a na. orrl <br />rNSP,02 2013 CRC <br />This document mdy be lound ot...hrt o'.lly/vn /.santa-ana.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2ot, N Nwaz lTlre- <br />Permit Number: <br />",-/3q <br />? <br />Property Owner:LkLLIltc-2Vc ea <br />Contractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 />6\ eo,r, boxes below must be checked: <br />ACarbon 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 />Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />roo , 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 b functional. l, also, hereby certify that lwill retest the alarms per the <br />manufactu rer's in c\rons <br />lcheck onel tr Li cenSe d Contractor Property Owner <br />NOTE: Ihis sef-c ertilicotion is only used lor projects thot ollect the EXTER,OR ol the sttucturc. This <br />process is applicable ONLY to projeds whete occess to the inte or ol the dwelling by o Sonta And <br />lnspedor is not tequircd. <br />Signdture:Dote:zl ill 7c-/ <br />License #: <br />Have this completed form and the job-card readily available on final inspection!