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*-SNTA <br />ilA,ffi <br />P.O. Box 1988 (M-19) <br />Santa Ana. C492702 <br />(714) 647-s800 <br />ww.r Santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document moy be lound dt...http://v,,.,,nv. sa n ta -a na.or q,'pba.' <br />(Please use a black or blue ink ball-poinl lr) <br />Project Address:L L .a_ <br />S <br />Property Owner:lx r ?'1o S"J 3)cl r) <br />Contractor:Li cense #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild in gs. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R3L4.3 and R314.3.3 define <br />the req u ired locations. <br />O[sornboxes below must be checked: <br />d Crrbonmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedro ms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />ap ances (i.e. hot water heater, cooktop, furnace) or a fireplace <br />Smoke 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-o perated 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 />man ufacturer's instructions. <br />a7- 31- t'| <br />lcheck onel Li cense d ontractor Prop erty Owner <br />NOTE: Ihis serl- certilicdtion is only used for projects thot olJect the EXIERIOR of the structure. This <br />process is opplicdble ONLY to projects where dccess to the interior ol the dwelling by d Sdnta And <br />lnspector is not required. <br />Sig noture:(,aa'*r 61 C.^..Ay..,Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />I Permit Number: