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Plannirry & Boitding Agsrcy <br />m Civic Certer Plaza Ross Anflex <br />P.O. Box '1388 (Pt9) <br />Santa Ana, CA 92m2 <br />rn4) 647-sflX) <br />www.san ta-a na. orq <br />Smoke & CO <br />Alarm Affidavit <br />This doi.ument moy be lound tt...http ://www.santa-ana.or olpba/ <br />(ple€* u* a black or Hue in* ball-point op.n) <br />Project Address:2221 vJ * >trrA ,4"-iFf*-,c* Tzto-> <br />Permit Number:20t c 65# <br />Property Ourner:G*,A;)o- O 1,,,., <br />License #: <br />State of California requlres that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and R315.2 states ln part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R315.3 define <br />the required locations. <br />At* boxes below mgst be checked: <br />El'carbon monoxide alarms: Are installed outslde of each sleeping area in the immediate vicinity of <br />bedrooms and also on each leve{ of the dwelling. Alarrns are recommended in bedrooms with gas-fired <br />applignces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />dsmoke alarms: Are installed in each room used for sleeping in each hallway outsade of a steeping <br />room, and on each level ofthe dwelling- <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. Combi{ration Smoke/Co alarms nrust 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 t}le property owner of the above project. I further certify <br />that smoke alarms and carbon moaoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. <br />lche* one)tr Licensed Contractor Property Owner <br />NoTE: This ser-ceftilication is onty used lor projeas that afled the ExfERtoR oI the structure. This <br />pracess is opplicobte O|ILY to proieds where access to the interior ol the dwelling by o Sonto Ano <br />lnspedor is not required, <br />te:Da Y-?-/ tr <br />Have this completed form and the job-,card readily available on final inspection! <br />*-SANTA <br />NA,'Iffi! <br />Contractor: <br />Signature:,Or,."*l- fiL**