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*,,SANTA <br />NA/ffi <br />t <br />tPlanning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />AIarm Affidavit <br />rNSP-02 2013 CRC <br />This document mdy be lound dt...http:/l/A /vv. sa nta-ana.orq/pba/ <br />(Please 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 />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 required locations. <br />f\ aott boxes below must be checked; <br />$ C"rUon 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 />J <br />{ 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 proiect. 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 I will retest the alarms per the <br />man ufactu rer's instructiops <br />lcheck one)Licensed Contractor El Property Owner <br />NOTE: Ihis sef-certificotion is only used for projects thot oflect the EXTERIOR ol the strudurc. This <br />process is applicable ONLY to projects where access to the inteior of the dwelling by o Sonto And <br />tnspector is not required, <br />Project Address: <br />Property Owner:t: <br />License #: <br />Signoture:Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M"19) <br />Santa Ana, CA 92702 <br />(71i1)647-5800 <br />www.snnta-ana orq <br />I Permit Number: <br />1 <br />'t /1 <br />.)- )_ <br />I <br />Contractor: <br />i <br />I +--