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I <br />*,SNTA <br />NA,ffi <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) 647.5800 <br />www.santa-ana.orO <br />Smoke & CO <br />Alarm Affidavit <br />tNSP-02 2013 CRC <br />This document mdy be lound at...http : //www. sa nta -a na. o rqi p ba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:zCZo $ fo5e .,.,*Au< <br />Permit Number:( o( 9t L)f <br />Property Owner:Io< fi, 0o'r o, q( <br />Contractor:t9t1 5u494c2 6rru,,License*:/Z?51JJ- <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />build ings. <br />California Residential Code (CRC) Section R314.1 and 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 req uired locations. <br />f| so,tr boxes below must be checked:t\ <br />ft"rUon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />/budroom 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 />E(rnof . 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 governing <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />ma n ufactu rer's instru ns <br />lcheck onel Licensed Contractor tr Property Owner <br />NOTE: Ihis sef- certificotion is only used for projects thot oflect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects wherc dccess to the interior of the dwelling by o Sontd Ano <br />lnspector is not required. <br />Signoture:a z (.(o <br />Have this completed form and the job-card readily available on final inspection! <br />\ <br />I <br />I <br />Dote: