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*,,SANTA <br />NA,',t'ffi! <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />ww,v. santa-a n a. o rq <br />rNSP-02 2013 CRC <br />This document moy be found at...http://www. sa nta-a na.orq/oba/ <br />(Prease use a black or blue ink ball-point pen) <br />Project Address:e2t1 S TnrevtruL sf, <br />Permit Number:laTqb 57v <br />Property Owner:E A RLDS PLAT-,2 <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 R314.3 and R314.3.3 define <br />the required locations. <br />A ao,h boxes below must be checked: <br />El 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 />p Smoke 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 t\4arshall {SFM). Battery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above pro.iect. 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 />(check onel Lic e d Con ra cto r tr P roperty Owner <br />NoTE: Ihrs sef-c ertificotion is only used fot projects thdt dffect the EXTERIOR of the structure. This <br />process is opplicable ONLY to proiects where access to the interior ol the dwelling by o Santa Ans <br />lnspector is not required. <br />Signature:Dote:lltefrs <br />Have this completed form and the job-card readily available on final inspection! <br />ma n ufacturer's instructions. <br />tr <br />//1,r.-/