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*-SANTIA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />www. s a n ta-an a. orq <br />Smoke & CO <br />Alarm Affidavit <br />INSP.O2 2013 CRC <br />This document moy be found at..,http://wnrwv. santa-a na. o rq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:3H.+ S Pri,:-lrn qrr *t,rt" r\^/- O+ ggtut <br />Permit Number:l )\ I-7 <br />Property Owner:1 -lt \/t tt <br />License #: <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 Sectlon R314.3 and R314.3.3 define <br />the required locations. <br />.f\ eo,ir boxes betow must be checked: <br />E Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bed r ms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />iances (i.e. hot water heater, cooktop, furnace) or a fireplace.a <br />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 ce rtify th at I am the contractor or the property owner of th e above project. I fu rther certify <br />that smoke alarms and carbon monoxi ala s have been installed in compliance with the governing <br />Codes a have bee be fun ron ,a lso, hereby certify that I will retest the alarms per the <br />m a n ufacturer's instructio ns <br />lcheck onel nsed ContractorLi Prope Own I <br />NOTE: Ihis sef-certification is only used for projects thot offect the EXTERIOR ol the structure. This <br />process is applicable oNLY to projects where occess to the intefior ol the dwelling by o Santd And <br />lnspector is not rcquircd. <br />Signature:Ddte:a<J' <br />Have this completed form and the job-card readily available on final inspection! <br />tr tr <br />1,)-) <br />Contractor: <br />IWY