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*,SAI{IA <br />NA,ffi <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) 647-5800 <br />www,santa-ana.olq <br />INSP 02 20]3 CRC <br />This document mdy be found ot..,h ttp ://wvrw. sa n ta -a na. o rq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Add ress Zzo 0Y0rU€ fi\P <br />Perm it Number to\l0zte 1 <br />( <br />0<6r <br />YflartqProperty Owner: <br />COU\$NN($ S\rJ SDVIY License #:(.,lo; luu,t tlol <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 R314.1 and 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 />4\soth boxes below must be checked: <br />E 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 />El 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-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 />{check onel tr censed Cont ractor R Property Owner <br />NOTE: Ihls sef-certilicdtion is only used for projects that offect the EXTERIOR of the structure. This <br />process is applicable ONLY to Wojects where access to the interior of the dwelling by a Santa And <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />Signature:J Dote: <br />I <br />I <br />I <br />I <br />Contractor: