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*,,SNTA <br />NA,',tilHt <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 ot...htto ://rl,r,vw.santa-ana.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:D t-i t.) D-r+; t\) <br />Permit Number:to\ rc]) ) QB <br />Property Owner:Q-c,totlb <br />Contractor:BV &1f'1vl.a INC License #, qnLql <br />ma n ufactu re r's instructio <br />(check onel tr Licensed Contractor Property Owner <br />Signature:/---J,l Date: <br />L -zb-/? <br />Have this completed form and the job-card readily available on final inspection! <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (CRC) Section R314.1 and 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 />6\eo.h boxes below must be checked: <br />,d 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 />$Srnot 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 interlor 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 />NOTE: Ihis sef-c ertificdtion is only used for projects thot dffect the EXTERIOR of the structure. This <br />process is opplicdble ONLY to projects where access to the interior of the dwelling by o Sonta And <br />lnspectot is not required, <br />tr