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*,,SNTA <br />NAJhffi <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-s800 <br />www,santa.ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />tNsP-02 2013 CRC <br />This document moy be lound ot..hLtp ://wvw.santa-ela.ofslBba/ <br />(Prease use a black or blue ink ball-point pen) <br />Project Address:t(OZ Ena\t<t^ Av-e <br />Permit Number: <br />TJ <br />lo l\ o )']qG <br />Property Owner \otu" Ft n-\r".rl p1c, (Dlrii u,"1 License #:- , . -l il .\ <br />L <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California ResidentialCode (CRC) Section R3L4.1and 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 />A eoth boxes below must be checked: <br />rt^rAonmonoxide 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 />dS^oX.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 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 icensed ntractor Property Owner <br />NOTE: Ihis sef-certificotion is only used for projects thot dlfect the EXTER,OR ol the strudure. This <br />process is opplicoble ONLY to projects wherc occess to the interiot oI the dwelling by o Sonto And <br />lnspectot is not reguired, <br />Signoture:,4,/ril r2/"-/I i1 <br />Have this completed form and the job-card readily available on final inspection! <br />Contractor: <br />Dote: