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*,,SANTA <br />NA,hffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647.5800 <br />www.santa-ana <br />rNsP-02 2013 CRC <br />fhis document moy be lound dt-.-http ://w\ A/v. santa-ana.orqi pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:lQl? N] Lo,,rise . to^le Ctntq <br />Property Owner: <br />Contractor:OZoN€ fl*,t,^. I <br />License #:I e 6 qtt <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residentral 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 />Asottr boxes below must be checked: <br />E Carbon 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-f ired <br />appliances (i.e. hot water 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. 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 />ma n ufactu rer's instructions. <br />-23- I <br />lcheck onel E Licensed Contractor tr Property Owner <br />NOTE: fh,s serl-c edilicdtion is only used lor prcjects th(,t dffed the ErTERIOR of the strudure. This <br />process is opplicable ONLY to Nojects where occess to the interior of the dwelting by a Sontd Ano <br />lnspector is not required, <br />Date:Signoture: <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I I <br />lPermitNumber: I lOlq rl4 i?