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Planning & Building Agency <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />www.santa-an a.orq <br />Smoke & CO <br />AIarm AffidavitSNTA <br />NA,"'ffi <br />fuw <br />INSP-02 2013 CRC <br />This document may be found at... http.i /\,^4M,,/.Sa n ta-a na.o rq/p bal <br />(Please use a black or blue ink ball-point pen) <br />Permit Number: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild in gs. <br />California Residential 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 />A ao,rr 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 />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 stru ctions. <br />lcheck onel Licen se d Contractor Property Owner <br />Project Address:e-.s <br />o t1? <br />Property Owner:.Jo <br />Contractor:lt.d)c o{i License *, 51yl tS <br />Siqnoture:t,Dote r/; <br />Have this completed form and the job-card readily available on final inspection! <br />20 Civic Center Plaza Ross Annex <br />NOTE: fhis sef- certilicotion is only used lor projects thot qflect the EXTERIOR of the structurc. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by o Sonto Ana <br />lnspector is not required.