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rNSP-02 2013 CRC <br />This document may be tound dt... http://r Al v, sa n [a-ana.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Permit Number: <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 R314.1and 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 />fr\ eo,h boxes betow must be checked: <br />Q C"tUon 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 />\X 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. I further certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the goveming <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 />(check onel E , ticen sed tradgt,(Property Owner <br />NoTE: Ihis sell-certificotion ii only used for projeds thdt dllect the DCIERIoR ol the structure. This <br />process is opplicoble ONLY to projects where occess to the inte ot ol the dwelting by a Santa Ana <br />lnspedor is not required, <br />Have this completed form and the job-card readily available on final inspection! <br />GI s { <br />^lQ\l+8 t t <br />Property Owner: <br />+l.-3C <br />I )Dote: <br />r*O,SNIA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Centgr Plara Ross Anoex <br />P.O. Bor 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.s800 <br />www.9anta-an a_ orq <br />Smoke & CO <br />Alarm Affidavit <br />I Project Address: <br />License #: <br />Signoture: <br />II I I