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,--SANTA <br />NA <br />tLr$t\c <br />&ti[Jllic <br />lGt\0 <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />,/v,Mr/. sa n la-an a- ca <br />Smoke & CO <br />Alarm Affidavit <br />This document may be lound at..,h tt p:r i u,v"rv. san ta-ana. orq, cba, <br />(please use a black or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 R315.3 define <br />the requ ired locations. <br />6\ aoth 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />El'smote 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 pro.ject. 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. <br />lcheck onel Licensed Contractor tr Pro erty owner <br />NOTE: Ihis serr-c eftificotion is only used for projeds thot olfect the ErTERIOR ol the structure. This <br />process is opplicoble ONLY to prcjeds where occess to the interior oI the dwelling by d Sdnt(J And <br />tnspectot is not required. <br />Project Address:Zoo?- N il"t,"*"m- Dr. <br />Permit Number:\aq5L7V I <br />Property Owner:La<lou..r bro <br />Contractor:t,. )rt edirv Q6of,no{rao, fpi."nr" #, qrV\lo <br />a Dote:ZISignoture:) <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I