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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />Smoke & CO <br />AIarm Affidavit <br />NSP-02 2013 CRC <br />This document moy be lound ot...h ttp :i/wv/w. sa n ta -a na. o rq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:25OO N. PARK BLVD. <br />Permit Number: <br />Property Owner:MARIA DeL VAL <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 />f\ eotl, boxes below must be checked: <br />El 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 />M 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 Flre 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 test to be functional. l, also, hereby certify that I will retest the alarms per the <br />ma n ufactu rer's instructio s <br />(check onel Licensed Contractor Property ner <br />NOTE: Ihrs sef-certificotion is only used for projects thot aflect the EXTERIOR of the structurc. This <br />process is applicable ONLY to projects where access to the interior ol the dwelling by o Sdntd And <br />lnspector is not required, <br />Signature:) lz/tnl Date: <br />*,,SNTA <br />NA-'+ffi <br />Have this completed form and the job-card readily available on final inspection!