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*,,SANTA <br />ANAJffi <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, CA92702 <br />(714) 647.s800 <br />www.santa.ana.orq <br />rNSP-02 2013 CRC <br />This document moy be lound ot,,,htto://www. santa-ana.o rolobal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:711.5 South Van Ness <br />Permit Number:101102452 <br />Property Owner:Walter R. Wirtz <br />License #: 274400 <br />State of California requires that smoke and carbon monoxide (CO) atarms are installed in residential <br />b u ild ing s. <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 />fl 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 required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Ed 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 project. lfurther 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 />lcheck onel License d Cont tor tr Property Owner <br />NOTE: Ihrs sef-c ertificotion is only used lor projectsthot oflect the EXTERIOR oJ the structure. This <br />process is applicoble ONLY to projects where occess to the interior ol the dwelling by o Sontd Ano <br />lnspector is not required. <br />Signoture:,Dote:06/29n020 <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />Contractor: <br />I