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*NSNIA <br />NA <br />PLI\\\C <br />& [IIIDI\G <br />l6rin <br />Planning & Building Agency <br />20 Civic Center Pla2a Ross Anner <br />P.O. Box '1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www santa-ana,otc <br />Smoke & CO <br />Alarm Affidavit <br />INSP.O2 2013 CRC <br />This document moy be lound ot...http ://w'/V\v.santa-ana.orq/pba/ <br />(P/ease use a black or blue ink ba -point pen) <br />Project Address:L27-5. su sAtr. >l <br />Permit Number:lot9coa, <br />Property Owner:t h? Cov.F. t/eloiru cz <br />Contractor:License #: <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 />A aotfr boxes below must be checked: <br />EI 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 lwill retest the alarms per the <br />manufacturer's instructions. <br />lcheck onel tr nse d Cont ctor EL Property Owner <br />NOTE: Ihrs sef-certiftcotion is only used for projects thdt dlfect the EXTERIOR of the structure. This <br />process is applicable ONLY to prcjects where occess to the inteiot ol the dwelling by o Sdnto Ano <br />lnspedor is not required. <br />Signdture:,f,l rl <br />.v' ( LPl Dote:rt/)5 <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I