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l0Permit Number: <br />Property Owner:6- <br />i a-cContractor:License #: <br />INSP.O2 2013 CRC <br />This document mqy be found at...htto://ww,v sa nta-ana.orq/pbai <br />(Please use a black or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California ResidentialCode (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 />Q r*n boxes below must be checked: <br />dCarbonmonoxide 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 />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Smoke 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 Flre 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 wrth 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 tr Licensed Contractor Pro perty Owner <br />I ,,.c <br />(r/'( <br />NOTE: Ihrs sef-certificdtion is only used for prcjects thot affect the EXTERTOR of the silucturc. This <br />process is applicoble ONLY to prciects where occess to the interiot ol the dwelling by o Sonto Ano <br />lnspector is not requircd, <br />Have this completed form and the job-card readily available on final inspection! <br />)1t+Iba <br />**SNTA <br />NAqffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box'1988 (ir.'l9) <br />Santa Ana. CA 92702 <br />(714) 647.s800 <br />www.santa-ana.olq <br />Smoke & CO <br />Alarm AffidavitI <br />le,"ie"teaa,ess, i /4f g?it4ytltr0F. _Cprta lupc* ?thl i <br />I <br />Signature:) oot",I