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*,SNTA <br />NA <br />[r\$c <br />IlmJl\C <br />lfl\0 <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Cente. Plaza Ross Annex <br />tNsP-02 2013 CRC <br />fhis document moy be lound ot...htto://www. sa n ta-ana.oro/Dba/ <br />(Please use a black or blue ink ball-point pen) <br />Y), <br />State of California requires th at smoke and carbon monoxide (CO) alarms are insta lled in residentia I <br />b u ild ings. <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 aotn boxes below must be checked: <br />EJdraonmonoxide 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 />applialres (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />(^olr"a la rms: Are installed in each room used for sleeping, in each hallway outside of a sleepinB <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 lam 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 instructions. <br />lcheck onel tr Licensed Contractor tr Property Owner <br />NOTE: Ihis sef-certification is only used for projects thot alled the EXTERIOR ol the structure. This <br />process is dpplicoble ONLY to projects wherc access to the interior of the dwelling by a Sontd Ano <br />lnspector is not required. <br />Project Address:tb a--o u- <br />Permit Number: <br />Property Owner:e-t{e--.t/U <br />Contractor:]-a License #: <br />Signoture:,7v Dote:l0-lo-\? <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 />(71/t) 647-s800 <br />www,santa-ana.orq <br />6