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*,SNTA <br />NA,rffii <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 />www.santa-ana.oro <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document mqy be lound ot...http://wwv. santa-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:l.oz (eyi-* CuftPr <br />\ D \ \ozlsc9 <br />Property Owner: <br />Contractor:Co.-Aan4r -1-e-*License #: 1?ZCt-l I C-.lto <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <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 />f\ ,o,n boxes below must be checked:I <br />B Carbon 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 />ap2liances (i.e hot water heater, cooktop, furnace) or a fireplace. <br />d 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 pro.ject. 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 />manuf acturer's instructions. <br />lcheck onel Licensed Contractor tr Property Owner <br />NOTE: Ihrt sef-certificdtion is only used for projects thdt dflect the ErTERIOR of the structure. This <br />process is applicable ONLY to projects where access to the interior oI the dwetling by o Santa Ano <br />lnspector is not required, <br />Dote 4 [q lzozo <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I Permit Number: I <br />I Signoture:I