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*-SANTA <br />NA-"'ffit <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 />,&,/v./l/ santa-ana or! <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:\Jr-r=T- a._ <br />Permit Number:(tol G(,>-z <br />Property Owner: <br />Contractor:License #:t.t/a c-ra <br />rNSP-02 2013 CRC <br />This document may be lound at...h ttP://r,nr',,,1t. sa nta-a na orq/Pba,' <br />(P/ease use a black or blue ink ball-point pen) <br />Siqnature:Do!e: <br />(check one) y Licensed Contractor Property Owner <br />NOTE: Ihrs sef'c ertificdtion is only used for projects thot affect the ErTERIOR of the structure. This <br />process is opplicoble ONLY to projects where access to the interior of the dwelting by a Sonto Ano <br />lnspector is not required. <br />2 <br />Have this completed form and the job-card readily available on final inspectionl <br />jG 1o S, Gess2 <br />.1='e-&\./^\ <br />qsqoa5 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <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 />A roan boxes below must be checked: <br />dC^rdonmonoxide 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 />Efsmoke alarms: Are installed in each roorn 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 alteratjons 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 LO 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 governrng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />ma n ufactu re r's instructions. <br />ac. 24.18