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.1 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 />(714) M7.5800 <br />www.santa-ana.or <br />Smoke & CO <br />Alarm AffidavitC'"'O'SANTA,N4,ffi <br />INSP.O2 2013 CRC <br />This document moy be found at h ttp : /iwww. sa nta-a na. o rq/o ba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:22o't w. g1yr1 gg"-9.gy 01_ <br />Permit Number:td lloz>t'l <br />el"lirq f"vreaoProperty Owner: <br />Contractor:pU1!/4 6r,cFtule License #:loE1o 90 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />Ca! -Jrnia Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />" itrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the req u ired locations. <br />fh sotl', boxes below must be checked; <br />ts 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 />dsmoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleepang <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 pro.lect. 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 />manufacturer's instructions. <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: Ihrs sef-certilicotion is only used for projects thot alfect the EXTERIOR of the structure. This <br />process is opplicable ONLY to prcjects where dccess to the interior ol the dwelling by d Sdntd And <br />lnspector is not required, <br />.{}\f\/- <br />Have this completed form and the job-card readily available on final inspection! <br />Signdture:l/ e'Zf'czzz- Z Dote:l-l-zo