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INSP{2 2C]3 CRC <br />fhis document moy be lound dt...httc / 'I,.r'sant3-ana orqi oba,' <br />(P/ease use a black or blue ink ball-point pen) <br />*-SNTA <br />NAffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />Project Address: 7O t )011 N Erra"{r," ^Permit N umber:30 t3.DLq <br />Property Owner:Loo1, g Earcrt <br />Contractor:License #: <br />State of Californla requires that smoke and carbon monoxide {CO) alarms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofltted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required loca tions. <br />A eo,t boxes below must be checked: <br />tJ <br />P Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />6edrooms 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 />*J-\fl Smofe alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />rodm, and on each level of the dwelling. <br />Retrofitted detectors may be ba ttery-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 yeai.s. <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 />manuf acturer's instructions. <br />S ignatu re:-4. 0,,r*'"".-^ ll*Dot ?:7 -.)f '/7 <br />lcheck oneJ tr Licensed Con tractor P roperty Owner <br />NOTE: fhis self-certificotion is only used lor projects thot dffect the EXTERIOR ol the structurc. This <br />ptocess is applicable ONLY to prcjects where occess to the interior ol the dwelling by d Sonto Ano <br />lnspector is not requhed. <br />Have this completed form and the job-card readily available on final inspectionl <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647.s800 <br />w!\ ,v sant3-ana.otq