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**SNTA <br />NAffi <br />Planning & Building Agency <br />20 Civic Center PIaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 6.17"5800 <br />anta-ana orq <br />Smoke & CO <br />Alarm Affidavit <br />rNsP-02 2013 CRC <br />This document mdy be found ot...http://$&w. santa-ana orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Contractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings, <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 required locations. <br />f\eoth boxes below must be checked: <br />SCrrbon monoxide 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. hofwater heater, cooktop, furnace) or a fireplace. <br />E(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 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. lfurther certify <br />that smoke alarms and carbon monoxide atarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />manufacture/s instructions. <br />(check one\tr Licensed Contractor Property Owner <br />NOTE: Ihis sef-certificotion is only used for projeas that allect the EXTERI1R ol the sttuctute. This <br />process is applicoble 0NLY to projects wherc occess to the interior of the dwetting by d sonto And <br />lnspedot is not required, <br />Project Address:6rs s r*di() S+ -+r81 <br />Permit Number:lDtq(tR r?YEtr/ Pt1t,C t"a; <br />5-P os"&.o.hRl-1-,,v License#: S-qVg\3 <br />Dote:I <br />l -- <br />Have this completed form and the job-card readily available on final inspection! <br />I Property Owner: <br />I I <br />I <br />Signoture: