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*,,SNTA <br />NA,Tffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />tNSP-02 2013 CRC <br />This document moy be lound ot.., h ttD / ,,,',ryi. Sa nta -a na .o rq 'pba <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:&rob S S a-t4 <br />^/)- <br />a *al <br />Permit Number:t0t1 \"ll ) <br />T Dl-lA- ?DUaJo <br />Contractor *tec*License #:qss oq6 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u 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 requ ired locations. <br />f\ ao*r 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-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />{ Slnot e 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 ha e been installed in compliance with the governing <br />Codes and have been te to be functional. l,, hereby certify that lwill retest the alarms per the <br />ma n ufacture r's instru <br />(check onel Contractor tr Property o ner <br />NOTE: Ihrs sef-ceftificotion is only used for projects thot olfect the EXTERIOR ol the structure, This <br />process is opplicoble ONLY to projects where occess to the inte or of the dwelling by o Sontd And <br />lnspectot is not required. <br />ron <br />Signoture:Date: <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />w.Jl./v sant3-ana orq <br />I <br />I <br />Property Owner: <br />t1