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*-SANTA <br />N4,"ffi <br />Planning & Building Agency <br />20 CiYic Center Plaza Ross Annex <br />P,O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />w'/v!v. s a n t a-a n a. orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP.O2 2013 CRC <br />This document may be found ot,,,http ://rrrlM,v. sa n ta-a n a.o rolpbal <br />(Please use a black or blue ink ball-point pen) <br />fiLE-3& S 11 <br />Perrnit Number:0lT7b5 <br />Garzr'A; WLE <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild in gs. <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 req uired locations. <br />, , Arornboxes betow must be checked: <br />L'- A Cai'bcn rncnoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedgoms and also on each level of the dweiling. Aiarrrr are ;equireC in bedroorns with gas-fired <br />ag-gliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />J' 17 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. 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 />m an ufactu rer's in structions. <br />6 1- <br />(check onel tr Licensed Contractor Property Owner <br />NOTE: fhls sef- certificotion is only used for projects that affect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by o Sdntd Ano <br />lnspector is not required. <br />927o)Project Address: <br />Property Owner: <br />Contractor:License #: <br />Signoture:Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />Qro*d -l