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NSP-02 2013 CRC <br />fhis document moy be found at..htto://ww/. san ta-a na.orq/pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address:)6/, d/na,t,ztz z/t/ <br />Permit Number:[6t13)31) <br />Property Owner:L <br />Contractor:koa h^lregt,?aor;^)License ht 9 z z?zg <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Resadential 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 />Aso,t boxes below must be checked:-7 <br />$y(arbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />b6drooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appli es (i.e. hot water heater, cooktop, furnace) or a fireplacec <br />moke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />oom, an d on each level of the dwelling <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall (SFM). Battery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. I further certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's in tructions <br />lcheck onel Licen sed Contractor P roperty Owner <br />NOTE: Ih,s sef-c eftilicotion is only used lot prcjects thdt olled the EXTERIOR of the strudure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by a Sdnto Ano <br />lnspector is not tequired. <br />Have this completed form and the job-card readily available on final inspection! <br />o*") ,/ri\? t \1Signature:\r- <br />*NSNTA <br />NA <br />[$nc <br />ritlun\c <br />lffi\0 <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. 8ox 1988 (M.19) <br />Santa Ana. CA 92702 <br />(714) 647-s800 <br />www,santa-ana.otq <br />Smoke & CO <br />AIarm Affidavit <br />I I <br />F