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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) 647-5800 <br />w.ww. santa -a n a- orcl <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:,?aoq g 4/z-t( -4vt <br />Permit Number:lo rQ f7z(6 <br />Property Owner:Cdlu /'r+ <br />-,> <br />Z- <br />rNSP-02 2013 CRC <br />This document moy be lound ot... h ttD:/^,,/vl,,r. Sa nta-a na.orq/pba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Contractor:S.-2*t_ 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 requ ired locations. <br />4l eotL boxes below must be checked: <br />EI 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-firecl <br />apgliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />d S-ot" alarms: Are installed in each room used for sleeping, in each hallway outside ot 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 />I signotur"t / rI lAan ,tl *z.az/01-\0-2ug <br />I <br />lcheck onel Licensed Contractor g P roperty Owner <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />Dote: <br />tr <br />NoTE: Ihis sef-c ertifieotion is only used for projects that offect the EXTERIOR of the structure. This <br />process is opplicoble ONLY to projects wherc occess to the interior ol the dwelling by a Sonta Ano <br />lnspector is not requited.