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Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex I <br />P.O. Box'1988 (M-'19) <br />Santa Ana, CA 92702 <br />(714) M7-s800 <br />w\Mr/ santa-ana orq <br />INSP.O2 2D I3 CRC <br />This document mdy be found ot..http://wvrw.santa-ana orq/pba/ <br />(Please use a black or blue ink ball-poinl pen) <br />Property Owner: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that exlsting 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 />f| aoth boxes below must be checked: <br />EI <br />SI carbon monoxide alarms: Are installed outside of each sleeplng area in the immediate vicinity of <br />6edrooms and also on each level of the dwelling. Alarms are required in bedrooms with gasJired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />f,Srnot" alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />4oom, and on each level of the dwelling. <br />Retrofitted detectors may be b a tte ry-ope rated for bu ildings where no interior alterations are <br />performed. Comblnation 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 proiect. I further certify <br />that smoke alarms and carbon monoxide alar ms 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 />manufacturer's instructions. <br />lcheck one)tr Licen sed Contractor Pro erty wner <br />NOTE: Ihrs sef-c ertificdtion is only used for projects that affect the EXTERIoR ol the stucture. This <br />process is opplicable ONLY to proiects where dccess to the interior of the dwelling by a Sdnta Ana <br />lnspector is not required. <br />Project Address:ZfK"s- fulq Way <br />Permit Number:// / q lJ tl <br />Qau/d llottlen <br />License *: tlb J-bJ-Contractor Ottne-Pa*t ,(.afiia <br />Siqndture:A 'q7 Dote:v <br />Have this completed form and the job-card readily available on final inspection! <br />*-SANTA <br />NA#ffi