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;,$Al'lTA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box '1988 (lt/.19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />w,l"/'I/.s ante-an a. orq <br />Smoke & CO <br />Alarm Affidavit <br />[.]sP-02 2013 CRC <br />This document may be t'ound at...httC.i /,/A'/',v Santa-ana.o T q,/obai <br />(Please use a black or blue ink ball-point pen) <br />5J5 NooD sT -qANTA A^/A cA 12-1,c3 <br />Permit Number:ptqSz L <br />Property Owner:JOH N L€C)AI'I€C <br />Contractor:P-PP P.4 Y License #;loLtL €Ta <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <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 req u ired locations. <br />{)rornboxes betow must be checked: <br />dc"rUon 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 />aOOpnces (i,e. hot water heater, cooktop, furnace) or a fireplace. <br />ESmoke 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 batte ry-ope rated 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 b <br />manufacturer's in <br />ee to be functiona . l, <br />_also, <br />hereby certify that I will retest the alarms per the <br />(check onel ensed Contractor Pro perty Owner <br />Have this completed form and the job-card readily available on final inspection! <br />ru ct io <br />te <br />Signature:@ Ddte:,l 1 <br />Project Address: I <br />NOTE: lhis self-certificotion is only used for projects thot olfect the EXTERTOR ol the structurc. This <br />process is applicoble ONLY to projects where occess to the interior of the dwetting by o Sonto Ano <br />lnspector is not required.