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*,,SANTA <br />NA <br />I.$lNG <br />titll"0Nc <br />lct\tl <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 />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP,O2 2013 CRC <br />This document mqy be found dt...htto ://www. santa-ana.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2ltob -1. Lnvell i)F <br />Permit Number:lo ttt657 <br />Property Owner:YuuT ct+un71ln7 <br />TilE WoFlvb Ca.License #:l0lvl10 <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 R31.5.2 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 />A uo,t boxes below 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 />El 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 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 pro.ject. 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 lwill retest the alarms per the <br />manufacturer's in r rons <br />lcheck one Licensed Contractor Property Owner <br />NOTE: Ihis sef-certificotion is only used for projects that allect the EXTERIOR ol the strudure. This <br />Nocess is opplicoble ONLY to projeds where occess to the inte or of the dwelling by o Sdnta Ano <br />lnspector is not required. <br />Signoture:r Dote {'tT-t7 <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />lContractor: <br />tr