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,--SANTA <br />NA-'ffi <br />Planning & Building Agency <br />20 Civlc Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714].647-5800 <br />www,s anta-an a. oro <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:20?: N ,<- lr <br />J CR.. <br />Permit Number:t0 rl O2 o <br />Property Owner:v-.5 c\ 5ao <br />Contractor:.rxQ.A License #:q <br />State of Californi <br />b u ild in gs. <br />This document mdy be lound ot http://www <br />rNsP,02 2013 CRC <br />santa-ana,oro lgbal <br />(Please use a black or btue ink batt-point pen) <br />a requires that smoke and carbon monoxide (co) ararms are instaired in residentiar <br />(check onel tr Licensed Contractor P rop erty owner <br />California Residential Code (CRC) Section R314.L and R315.2 states in part that existing dwellings be"retrofitted with smoke alarms and carbon monoxide alarms. cRc section R314.3 and R314.3.3 definethe requ ired locations, <br />f| ao*r boxes betow must be checked: <br />d c"'bon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity ofbedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-firedappliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleepingroom, and on each level of the dwelling. <br />Retrofitted detectors may be battery-ope rated for buildings where no interior alterations areperformed. Combination Smoke/CO alarms must.orply,iith all applicabte,t.na.rlilni be approvedby 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 certifythat smoke alarms and carbon monoxide alarms have been installed in compliance with the governingCodes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per them a n ufacturer's instruction s. <br />NorE: rhls sef- certification is only used for proiects that affect the EXTER17R ol the structurc. Thisprocess is opplicable oNLy to projects where access to the interior of the dwetting by a sonta Anulnspector is not required. <br />HaVa this Camnlcfcd fnrrvr :nd tha iatr_^ar.t ,^^ril., ^.,_:r_Lr_ _- r!_-r <br />Signoture:,'l <br />9.t.I Ddte:I ^ l.'t o <br />I <br />I <br />lr <br />I