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*,SNTA <br />NA,ffi <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) M7-5800 <br />ta-ana or? <br />Smoke & CO <br />Alarm Affidavit <br />INSP,O2 20] 3 CRC <br />fhis document may be found at...htto:/1r lm/v. sa nta -a na.orq/oba,/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address ?3\( 5 Moddn,,r 51 Santa Anq ,tA 1tlcl"t <br />Permit Number:I0\qr 5qs <br />Property Owner Pedro z avlacct <br />Contractor:CW nlr'-Rr,r\cl-l-v-License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild 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 R314.3 and R314.3.3 define <br />the requrred location s. <br />A eoth 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 />E 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 />ma n ufactu re r's instructions. <br />leheck onel Licensed Contractor Property Owner <br />NOTE: Ihrs sef-certificdtion is only used lor prcjects thdt dflect the EXTERIOR of the structure. This <br />process is applicdble ONLY to projects where access to the interior of the dwelling by a Santa Ana <br />lnspector is not required. <br />Signoture I Dote 9-fo -/B <br />Have this completed form and the job-card readily available on final inspection! <br />tr