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*-SNTA <br />NA,'iffiI <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />OZ , <br />Permit Number:lo lcs :7 *-Z--- <br />Property Owner: <br />License #: <br />rNSP-02 2013 CRC <br />This document mdy be lound ot.htto://www sa nta-ana.orq/oba/ <br />(P/ease use a black or blue ink ball-point pen) <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 required locations. <br />flro,n boxes below must be checked: <br />ft C"rUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />Tbetrooms and also on each level of the dwelling. Atarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />A Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />/robm, 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. lfurther certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governtng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />man ufactu re r's instructions. <br />(check onel tr Lacensed Contractor Property Owner <br />NoTE: Ihis sef-certificotion is only used for projects thot affect the EXTERtoR ol the structure. This <br />Nocess is aPplicoble ONLY to projects where dccess to the interior of the dwelling by o Sonto And <br />lnspector is not required. <br />d I Date:o t -t-l -1o <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm AffidavitP.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.orq <br />Project Address: I <br />I <br />I <br />lContractor: <br />I <br />Signoture: ) <br />tr <br />I .ln\^,,