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*,SANTA <br />NA,tffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 19BB (Ml9) <br />Santa Ana, CA 92702 <br />(714) M7.5800 <br />w,r/w santa-ana crq <br />Smoke & CO <br />Alarm Affidavit <br />lNSP-02 2013 CRC <br />fhis document moy be found ot..h ttp:/,\r'lr'/,/,/. santa -a na.or-q/pbai <br />(P/ease 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 />b u ild ings. <br />California Resadential 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 aoth boxes below must be checked: <br />E Carbon monoxide alarms: Are installed outside of each sleepang 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 ali 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 governrng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instructions. <br />(check one)Licensed Contractor Prope ner <br />NOTE: Ihrs sef-c ertificdtion is only used for projects thot dffect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior ol the dwelling by o Santa Ana <br />lnspector is not required. <br />Project Address:?t t r,,l)0,f+ <br />Permit Number:1o/7 7>/ L <br />Property Owner:t(hL <br />Contractor:ilaw)-L'b ZLicense #:o <br />Signoture:-//4th.U Date:{t to <br />Have this completed form and the job-card readily available on final inspection! <br />tr