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,-,,SANTA <br />NA,'ffi <br />Planning & Building Agency <br />20 Clvic Center Plaza Ross Anncx Smoke & CO <br />Alarm AffidavitP.O.8ox 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 617-s800 <br />tNSP.02 2013 CRCThii document msy be lound at...t3-ana.o ba,' <br />(Please use a black or blue lnk ball-point pen) <br />lllau <br />state of california requires that smoke and carbon monoxide (Co)alarms are installed in resadential <br />buildings. <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 required locations. <br />f\ eotrr uoxes below must be checked: <br />on monoxlde alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />(i.e, hot water heater, cooktop, furnace) or a fireplace.appl ces <br />moke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />om, and on each level of the dwelling <br />Retrofitted detectors may be battery-operated for buildings where no interior alte.ations are <br />performed. combination srnoke/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 />lhereby certify that I am the con <br />that smoke alarms and carbon m <br />Codes and have been tested to b <br />manufacture/s instructlons. <br />tractor or the property owner of the above project. I further certify <br />onoxide alarms have been installed in compliance with the governing <br />e functional. l, also, hereby cerrify that lwill retest the alarms er the <br />Qheck onel tr Licensed Contractor dl <br />t' <br />W hPro <br />l|I'lCVtj <br />{r,t <br />Ll'\<( <br />' ttz)(-t t <br />NorE: rhis sef{enificdtion is only uted lor prcjects thdt dllect the F!$ERloP ol the structute This ,i11 <br />\uprocess is opplicable ONL <br />lnspector is not required. <br />Y to ptoiects whete occess to the interior of the dwelling by a Sonta Ana <br />Project Address:?t1 LEF| lE{L ( <br />Permit Number: <br />Property Owner:L <br />Contractor: <br />Signoture:Date <br />Have this completed form and the job-card readity available on final inspection! <br />I <br />I <br />I