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*,,$NTA <br />NAffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.l9) <br />Santa Ana, CA 92702 <br />(714)647.5800 <br />a-ana orq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document may be lound at...htto a n ta-a na.orq/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address: <br />Permit Number:btq L7t <br />Property Owner:iVlirrr <br />Contractor:C ,{+I Li ose #: C1e g1 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 required locations. <br />4\ eot| boxes betow 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 ba ttery-operated for bulldings 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 lam 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 governrng <br />Codes and have <br />ma n ufacturer's <br />been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />strutfidn s <br />lcheck one)tr Licensed Contractor pe y OwnertrPr <br />NorE: rh,5 sef'c ertificdtion is only used Jor projects that affect the EXTERIoR of the structurc. This <br />process is opplicable oNLy to projects where occess to the interior of the dwe ing by o sonto Ana <br />lnspector is not required. <br />Signature:Oote:8t do/ <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />II