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rl <br />*,,SANTA <br />NA <br />ILI\\]IC <br />ilulJt\c <br />rct\fl <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647.s800 <br />www.santa.ana.orq <br />Smoke & CO <br />AIarm Affidavit <br />tNSP-02 2013 CRC <br />This document moy be Iound ot...http.//www. santa-a na.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:iA)\ U. -P\ou-rr,.r sL ).*rnk^ <br />^1t, <br />C^9 . <br />Permit Number: <br />Property Owner:D*,caVTrrrvrt Q'nx'y.kr [L(a*aq,r-^\ <br />A ( ennp,rta.7 tsll'tLicense #: <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 requ ired locations. <br />f) ro,n boxes below must be checked: <br />WCarbon 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 />appli es (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 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 />manufacturer's instruction <br />lcheck onel tr License C ractor Property er <br />NOTE: Ihis sel/-certilication is only used lor projects thot allect the ExTERIOR ol the strudure. This <br />process is dpplicoble ONLY to projects where occess to the interiot oI the dwelling by d Santd And <br />lnspedot is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Signotute:(')\"l,,bQ Dote:oZ)r'rlrx' <br />Contractor: <br />tr