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*-$NIA <br />NAffi <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 />w ,r!.r, sa nta -a n a. olq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document mdy be lound ot...http:/A,vrivw. sa nta-a na.orq/pba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:7110 -f. Ifia,-t lT <br />Permit Number: <br />Property Owner: <br />ol16ozt <br />[glA.^^A GCtZt *,'l <br />Contractor:P9htnx, b-.t), A License #: 1l+ ZZ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that ex,sting 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 />(Aeornboxes 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 required in bedrooms with gas-fireci <br />apprfi6nces (r.e. hot water heater, cooktop, furnace) or a fireplace. <br />E Smoke alarms: Are rnstalled in each room used tor sleeping, in each hallway outside of a sleeprng <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 project. lfurther 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. l, also, hereby certify that lwill retest the alarms per the <br />manufacturer's instructions. <br />(check onel Licensed ontract0r tr Property Owner <br />NOTE: Ihls sef-c ertificdtion is only used for projects that oflect the EXTERIOR of the structure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by a Santa An(, <br />lnspector is not requircd. <br />Z-.'/2.*/<-Signdture Dote:6-es- l{ <br />Have this completed form and the job-card readily available on final inspection! <br />I