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\ <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit*-SNTA <br />ANA-tffi <br />rNSP-02 2013 CRC <br />This document may be lound at...htto://www.santa-a na.oro/oba/ <br />(Please use a black or blue ink batl-point pen) <br />lsProject Address: <br />Permit Number: <br />Property Owner:C,Il y1 <br />Contractor:License #:q56sq3Jpect4I <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildin gs. <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 req u ired locations. <br />A ao,h boxes below must be checked: <br />El 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 />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 />m a n ufacturer's in struction s. <br />Signoture:ec;Lza-L p<rnxT Dote:/-L-/ E <br />(check onel tr Llcensed Contracto r w Property Owner <br />NOTE: Ihri sef- certification is only used for projects thot dflect the EXTERTOR ol the structure. This <br />process is applicable ONLY to projects where occess to the interior ol the dwelting by a Sdnto Ano <br />lnspector is not required. <br />Have this comoleted form and the iob-card readilv available on final insnection! <br />I <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />www,santa-an a.orq