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*-SANTA <br />NA-'qffi <br />Planning & Building AgencY <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-'19) <br />Santa Ana, CA 92702 <br />(714)647-5800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document moy be lound at...htto://www. santa-ana orolobal <br />(Please use a black or blue ink ball'point pen) <br />Project Address:)1Lo \ve tt <br />)11 0 6s? <br />Property Owner: <br />-Fa,*e il 6"ldcr'o <br />Contractor:License #: <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 />fl ,oan boxes below must be checked: <br />dC.rbon monoxide alarms: Are instatled 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 />Et'Smoke alarms: Are installed in each room used for sleeping, ln 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 alteratlons 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 />ma n ufacturer's instructions <br />lcheck onel Licensed Contractor Pro e rty wner <br />NOTE: Ihis sef-c eftilicotion is only used Jor projects thot ollect the EXTERIOR oI the structure. This <br />process is appticdbte 1NLY to proiects where dccess to the interior of the dwelling by o sontd ano <br />lnspector is not required. <br />: <br />7lDdte:du(LtrdSignature: <br />Permit Number: <br />tr