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Smoke & CO <br />Alarm AffidavitP.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />ta-ana.orq <br />rNSP-02 2013 CRC <br />This document moy be found ot...htto://\,/wv/.sa nta-a na.oro/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:lr tu uJ . tre6 [nni <br />Permit Number:f6r'{ <br />/o / / 0 ) <br />/h rrz { lA*rt <br />Contractor:4zr./ lhrr" S 7l/*lti"***" , r, vrr <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 />4\ eoth boxes below must be checked:JI <br />flCarbon 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 />lEsmoke 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 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 rn compliance with the governing <br />Codes and have been te fu ional. l, also, hereby certify that lwill retest the alarms per the <br />manufacture r's inst <br />lcheck onel P ntractor tr Property Owner <br />NOTE: fhis serf-certilicotion is only used lor projects thot dlfect the EXTERTOR ol the sttucture. This <br />process is applicable ONLY to projects wherc occess to the interior ol the dwelling by d Sdnto And <br />lnspector is not required. <br />ions. <br />Signoture:(Dote:>r/tz/z,t <br />L rce n <br />*,SNTA <br />NA-'ffit <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />Property Owner: <br />Have this completed form and the job-card readily available on final inspection!