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*,SANTA <br />NA-'hffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />INSP.O2 2013 CRC <br />This document moy be lound dt...http://ww/.santa-ana.or qipbai <br />(Please use a black or blue ink ball-point pen) <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in resldential <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 eoth boxes below must be checked: <br />B-Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bldrooms 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 />fsmoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />I <br />robm, 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 lwill retest the alarms per the <br />manufacturer's instructions. <br />(check onel Licensed Contractor F Property Owner <br />NOTE: Ihrs sef-c ertificotion is only used for projects that ofiect the ExTERIOR of the strudure. This <br />prccess is applicoble ONLY to projects where access to the interior ol the dwelling by d Santo Ano <br />lnspector is not required. <br />1oS e NruVoQt 2+Project Address: <br />Permit Number: <br />Signature I 0 .-z-7-/ -, <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box '1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647.5800 <br />www.santa-ana,oro <br />I <br />j Property Owner: <br />I <br />I <br />Date: <br />tr