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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box '1988 (M-19) <br />Santa Ana, C492702 <br />(7r,1) 647-5800 <br />www.Santa-ana,orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />4/ZZ u./ l,tr</et b // <br />Permit Number:fratz6r7u.o ly'o--lrze z /O/9zda <br />Property Owner:Ftut?ct<ro /l/al*zez- <br />Contractor License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 />Aaoth boxes below must be checked: <br />6Carbon 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 />E 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 lwill retest the alarms per the <br />manufacturer's instructions. <br />lcheck onel Licensed Contractor tr Property Owner <br />NOTE: Ihis sef-certiftcdtion is only used for projects thot alled the ErTERIaR oI the structure. This <br />process is applicoble ONLY to projeds where access to the interiot of the dwelling by a Santd And <br />lnspector is not required, <br />Signoture:,44 Dote:7 -/7"zat3 <br />Have this completed form and the job-card readily available on final inspection! <br />*,,SANTA <br />NA,'IffiI <br />This document mdy be found ot... http://w1,$ . sa nta-ana.oro/pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address: <br />tr