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rNSP-02 2013 CRC <br />This document mdy be found qt...http //www. sa nta-ana.oro/Dba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:V"h <br />Permit Number:lo rlsSAs <br />bltfrEt* VhtW' <br />Contractor:/€rrreq pt*ty6 License *, 97f IEZ <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 required locations. <br />Aeo,h boxes below must be checked: <br />(C.rUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />6")roo.r.nd also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />app/iances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />fl Smofe 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 l0 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 />lcheck onel Licensed Contractor Property Owner <br />NOTE: Ih,s serl-certificotion is only used lor projects thdt dllect the EXTERIOR of the strudure. This <br />process is opplicoble ONLY to projeds wherc occess to the interior oI the dwelling by a Santo Ano <br />lnspedot is not rcquired, <br />Have this completed form and the job-card readily available on final inspection! <br />Signoture:*--"j>:Dote:{-zz-17 <br />*-SANTA <br />NA <br />It$1;l\c <br />IBUUNC <br />lct\0 <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) 6il7-5800 <br />www.santa-ana.oao <br />Smoke & CO <br />Alarm Affidavit <br />I 222<- <br />tr <br />Property Owner: