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**SANIA <br />NA,'IffiI <br />Planning & Bui.g Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center plaza s Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714],647-s800 <br />na.orq <br />This document mdy be Iound at... h ttp://wwrr,l <br />rNSP-02 2013 CRC <br />sant a-ana.orclobal <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address: <br />Permit Number: <br />state of california requires that smoke and carbon monoxide (co) alarms are installed in residentialbuildings. <br />California Residential code (CRC) section R314.1and R315.2 states in part that existing dwellings be"retrofitted with smoke alarms and carbon monoxide alarms. cRC section R314.3 and R314.3.3 definethe req uired locations. <br />A ao,h boxes below must be checked: <br />$ c"'bon monoxide alarms: Are installed outside of each sleeping area in the rmmediate vacinity of'6edrooms and also on each rever of the dweling. Ararms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.'p <br />smot<e alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping1room, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations areperformed combination smoke/Co alarms must comply with all applicable standards and be approvedby 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.iect. I further certifythat smoke alarms and carbon monoxide alarms have been installed in compliance with the governangcodes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per themanufacturer's instructions. <br />(check onel tr Licensed C ontracto r roperty owner <br />NorE: rhrs sef- certificotion is onty used for projects thot alfect the EXTERrcR of the structure. Thisprocess is opplicoble aNLY to proiects where occess to the interior of the dweling by d sontd Anolnspector is not required. <br />l'r),cdOA sJTA flTtt5C0t <br />/0tq q6 <br />Property Owner:a.n'lon R tVefCL <br />) <br />Contractor:rt License #:loD <br />Signoture:L Ddte:t2 -,1 -t t <br />Have this completed form and the job-card readiry avairabre on finar inspection! <br />II <br />I <br />I <br />I <br />I <br />,l <br />t \