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*-SANTA <br />NA-tffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaua Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(7'r4) 647-5800 <br />v/.,r i/ slntil-il..ta or{'l <br />tNsP-02 2013 CRC <br />This document moy be lound dt,,. h ttD:/4,,1:i,y. sa n ta-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:L, T uJ. [ue| [oii <br />Permit Number:0 t 6r' <br />Property Owner:/h rrz { /,q*rt <br />Contractor:4 a,l lh>r" S L/r>l ticense i 2 qa / r / <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California ResidentialCode (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 />fl eoth boxes below must be checked: <br />PCarbon 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 />E5moke 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. lfurther certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been te fu ional. l, also, hereby certify that I will retest the alarms per the <br />man ufactu re r's inst <br />lcheck onel P on tractor tr Property Owner <br />NOTE: Ihrs sef-c ertilicotion is only used lor projeas that olfect the EXTER//OR of the structurc. This <br />process is applicable ONLY to proiects whete occess to the interior ol the dwelling by a Sdntd Ano <br />lnspector is not required, <br />rons. <br />Signoture:()Dote:>/tt/zt <br />Lice n <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I