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*,,SANTA <br />NA <br />tLt\l\6 <br />ltutDlic <br />l0i(1 <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) 6i17.5800 <br />www.santa.ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP{2 2013 CRC <br />This document moy be lound ot..trttp, {wwry. sa nla - arc . otqlp ba/ <br />(Prease use a black or blue ink ball-point pen) <br />Project Address:420 O-()/-t€,tfFAl <br />Permit Number:lotqsrs"c <br />Property Owner:L)ar*- .* l)a ,,*, rfi/l/r-7 License #:/ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 />A eottr 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 />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 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 />ma n ufacturer's instructions. <br />lcheck onel tr Licensed Contractor a Property Owner <br />NOTE: Ihis sef-certilicotion is only used fot projects thot ollect the EXTERIOR oI the strudure. This <br />process is opplicable ONLY to projeds where occess to the interior oI the dwelling by o Sonta Ana <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Z Date /,t2 /7 <br />I <br />lContractor: I <br />Signoture: <br />i <br />I