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*,,SNTA <br />NA.Iffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(7r4) 647-s800 <br />w.,.a;,,.sint:l.an I oral <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document mdy be found at...http://v,A,,$/. sa nta-ana.orq/pba/ <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 />bu ildings. <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 R314.3.3 define <br />the required locations. <br />4\ soth boxes betow must be checked: <br />ft1C"rUon 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-fired <br />L appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />I <br />Q Smofe alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />fom, 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. 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. I , also, hereby certify that I will retest the alarms per the <br />manufacturer'ruct <br />lcheck onel Li sed Contractor Prope Owner <br />NOTE: Ihis sef-certilicdtion is only used lor projects thot allect the EXTERIOR ol the strudure. This <br />process is opplicoble ONLY to projeds where access to the interior of the dwelling by o Santo Ano <br />lnspedor is not required. <br />Project Address: <br />Permit Number: <br />lr! - Lr ruv,rcofi <br />/ottn E?la <br />0 <br />Property Owner:tl-ortlarLET <br />Contractor:License #: <br />rns <br />Signatute:;Dote:3l <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />0 3 <br />I