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*-SNIA <br />NAffi <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-s800 <br />ta-ana.ore <br />INSP-02 2013 CRC <br />This document moy be lound at...htto:/AMMr'i.santa-ana.or q/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address: <br />lcheck onel F License Contractor Property Owner <br />NOTE: fh6 sef-c ertificotion is only used lor proiects thot dllect the EXTERIOR of the structure. This <br />process is opplicoble ONLY to projects where occess to the interior ol the dwelling by o Sonta Ano <br />lnspector is not required. <br />2\0\ 3 ?o.uG,c Aw U43 <br />Permit Number:Ior q5lq81 <br />Property Owner: <br />/tu1Contractor:License #:nc <br />signoture: l. ((h/ llr,nrtqtrlr Dote:os/t3/zoQ, <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />I I <br />I <br />I <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 />fl so,h boxes below must be checked: <br />\J <br />F{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 iequired in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />lXl 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 governlng <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />ma n ufacturer's instructions,