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,,,SANTA <br />NAJII}ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box'1988 (Ml9) <br />Santa Ana. CA 92702 <br />(714) 647-s800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP-02 2013 CRC <br />This document moy be lound ot...http.//www.santa-ana.orq/pba/ <br />(Please use a black ot blue ink ball-point pen) <br />Project Address:ba €1)q*5< 4"k^ aJx Zl. 1taau <br />Permit Number:pt41q15 <br />Property Owner tU$- t Dt]lo{@ t_\*tq,TL <br />n;,,ewe,aw*.License #: loZ3?o5 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed rn residential <br />build 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 R31.4.3 and R31.4.3.3 define <br />the requ ired locations. <br />Asott boxes below must be checked: <br />J <br />Aarbon 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 />pspoke 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 I will retest the alarms per the <br />manufacturer's instructions. <br />(check onel Lice e d Contractor A Property Owner <br />NOTE: Ihis sef-certification is only used for projects thdt dllect the EXTERIOR of the strudure. This <br />process is applicoble ONLY to projects where occess to the interior oI the dwelling by o Sdnto Ano <br />lnspector is not required. <br />Signoture:Ddte 2:7/U//b>/& <br />Have this completed form and the job-card readily available on final inspection! <br />Contractor: