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*,SNIA <br />NA,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 />www,santa-ana.oro <br />rNsP-02 2013 CRC <br />This document may be found ot...htto://wvw santa-a na.orq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />ProjectAddresr, I 2b Zb l\A irorol , So,v*a ArM L\qztcS <br />Permit Number:lottn,l,+r47 <br />Property Owner J^.1 ; Vda ?c.rrve.Y" v-q <br />Contractor:I \I <br />License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu 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 requ ired locations. <br />f\ so,i, boxes below must be checked: <br />dCarbonmonoxide 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 (j.e. hot water heater, cooktop, furnace) or a fireplace. <br />EISmote 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 />ted to be functional. I , also, hereby certify that I will retest the alarms per the <br />ma n ufacture r's inst <br />(check one)tr rcens Contractor w Property Owner <br />NOTE: Ihrs sef-certification is only used for projects that dffect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the inte ot of the dwelling by o Sontd Ano <br />lnspector is not required. <br />Signature:IIM Y-r/Dote:( <br />II <br />Have this completed form and the job-card readily available on final inspection! <br />Codes and have been