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*,SANTA <br />NA <br />[r\\lc <br />& IIITJIIG <br />i(;ti$ <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />www.santa-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />lNSP-02 2013 CRC <br />fhis document moy be found ot...htt //www. santa-ana.or bai <br />(Please use a black or blue ink ball-point pen) <br />State of Ca lifornia requ at smoke and carbon monoxide (CO) alarms are installed in residentialst <br />bu ildings. <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 />Aeorh boxes below must be checked: <br />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-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Ei^oX"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 />man ufactu re/s instructions. <br />(check onel Licensed Contractor JL---Property Owner <br />NOTE: fh,s serr-certificotion is only used lor projeas thot olfed the EXTERIOR oI the strudure. This <br />process is opplicable ONLY to projeds where occess to the interiot of the dwelling by o Sonto And <br />lnspector is not rcquired. <br />/z/t lb 5l,)on eJ- <br />Permit Number /ol qqssT- <br />Property Owner:Cln'i t >-,---r lMq e t'q.\ <br />Contractor: <br />-'J,,tL' lLicense#: 4z z,=q <br />Signoture:4 /28 Date <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: <br />I