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,,,,SANTA <br />NA <br />ILI\]T[C <br />&lillJt\c <br />IGIIfi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(7't4) 647-5800 <br />www.santa-ana.oro <br />INSP-02 2013 CRC <br />This document may be lound dt...http://www. santa-ana.oro/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:LOLq \\ <br />Permit Number:r0 \l cqqR'' <br />Property Owner:\16,'1 gnr,^.- L-c,nrult <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in resldential <br />buildings. <br />California ResidentialCode (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 />A sott boxes below must be checked: <br />E 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 requrred in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />$ Smofe 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 />Signoture:ZZLtk-Dote l0 - zwzo <br />lcheck onel ts Property Owner <br />NOTE: Ihis serr-certif,cotion is only used for projects thot olfect the EXTERIOR of the structure. This <br />process is applicdble ONLY to projeds where occess to the intedor of the dwelling by o Sonto Ano <br />lnspedot is not rcquired, <br />Have this completed form and the job-card readily available on final inspection! <br />tr Licensed Contractor <br />I <br />I <br />I