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*-SANTA <br />NA,'ffi' <br />I <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(7'14) 647-s800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />tNSP-02 2013 CRC <br />This document moy be lound dt...htto://www. sa nta-ana.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:?a.z zy' < - -;4--.-/o,-J zZ.J - <br />Permit Number: <br />Property Owner:,%zo 2. 6azZ.z-.2,- <br />License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <br />California Residential Code (CRC) Sectlon 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 req uired locations. <br />flaoan boxes below must be checked: <br />#^rAonmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. AIarms are required in bedrooms with gas-fired <br />applinces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />ps^oiealarms: 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 I will retest the alarms per the <br />ma nufactu rer's instructions. <br />lcheck onel dcense tractorLi F-P rop Owner <br />NOTE: Ihis sef-certificotion is only used lor prcjeds thot offect the ErTERIOR ol the strudure. This <br />process is applicdble ONLY to prcjects where dccess to the interior oI the dwelling by o Sontd Ano <br />lnspectot is not reguired. <br />Signature:,%o- z /r,42-242-z Dote:A c>- <br />Have this completed form and the job-card readily available on final inspection! <br />Contractor: