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*JANIA <br />NA.ffi <br />Planning & Building Agency <br />20 C i/rc Center Plaz3 Ross Annex Smoke & CO <br />Alarm AffidavitP.O Box 1!88 (M-19 ) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />w ,r/tiv SJnta-ana.or? <br />fhis document moy be lound ot,.. <br />(please use a black or blue ink ball-point pen) <br />Proi""t aJoi".t' T <br />httc / ^dr,!'r'r' santa-ana.o <br />i h <br />Permit Number:/0/qr/q <br />Property Owner: <br />Contractor: <br />State of California requires that smoka and carbon monoxide (CO) alsrms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Section Rl14.L and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monox:Ce alarms. CRC Section R31r1.3 and R315.3 define <br />the required locations. <br />A aoth boxes below must be checked: <br />E Carbon monoxide alarms: Are installed outside of each sleeping area in the ir'tmediate vicinity of <br />bedrooms and also on each level of the dwelling. AIarms are recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater. cooktop, furnace) or a fireplace. <br />E Smote alarms: Are installed in each room used for sleeping, in each hailwa I 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 Mdrshall (SFNI). gattery life must be 10 years. <br />I hereby certrfy that I am the contractor or the property owner of the above project. I further certify <br />that smoke alargland carbon monoxide alarms have been ins:alled in compliance with the governing <br />Codes and hau/ \Aen tested to be functional. <br />(check on SE d Contractor Property Owner <br />NoTE: rhis sef-ce rtificotion is only used for projects thot dflect the EXTERIOR of the strudure. This <br />process is opplicable ONLY to projects where occess to the intetior of the dwelling by o Sonto And <br />lnspector is not required. <br />I License *, ?/5)tO <br />/Dote:/, <br />Have this completed form and the job-card readily available on final inspection! <br />a,n n4 <br />h/,b/< <br />Siqndtute: <br />tr