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Au~ 1 Be f ·rvlf'iJ.J). CA.t ~v'\" \ <br />or )V\ff!'clfo( TI7 ~ l)J-<eH .J-D <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.org <br />Smoke & CO <br />Alarm Affidavit <br />INSP-02 2013 CRC <br />This document may be found at... http://www.santa-ana.org/pba/ <br />(Please use a black or blue ink ball-point pen) <br />;VfT <br />Permit Number: O{'JIG7 <br />Property Owner: <br />Contractor: License#: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings . <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 required l ocations . <br />.o"\\soth boxes below must be checked : <br />Car 6 on monoxide larms: Are installe outside of each sleeping area i n the immediate vicinity of <br />edrooms and also on each level of the dwe · quired in bedrooms with gas-fi red <br />appliances (i.e . hot water heater, cooktop, furnace} or a fireplace . <br />l;Slsmoke alarms: Ar ~a t i ed i n~ roo~ used for sleeping, . ach hallway outside of a sleepin <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 l ife 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 be en in sta lled in compl i ance with the governing <br />Codes and have been tested t e-ftl-· na l. also, hereby certify that I will retest th e alarms per the <br />Signature: <br />(check one) Property Owner <br />NOTE: This self-certification is only used for projects that affect the EXTERIOR of the structure. This <br />process is applicable ONLY to projects where access to the interior of the dwelling by a Santa Ana <br />Inspector is not required. <br />Have this completed form and the job-card readily availabl e on final inspection!