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*,,SNTA <br />NA,ffi <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 />www.santa-ana.olq <br />Smoke & CO <br />Alarm Affidavit <br />|NSP,02 2013 CRC <br />fhis document mdy be found ot...hltp:/iwvryv.santa-ana.o rslobal <br />(Please use a black or blue ink ball-point pen) <br />Project Address:liq0 ! rt)v,vE( rr / 5A^/-A 4p+, C4 qz 7c7 <br />Permit Number:itl\Q \tctt Prpr'.j 1n 7q <br />Tcr, LE <br />)01?Z?qq pt-ririlulslb <br />Contractor:I UU r(vt) I (uv 5iLA(License#: l0u qtI -J <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 Section R314.3 and R314.3.3 define <br />the required locations. <br />6\aotl' boxes 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-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 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 alarms 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 />manuf acturer's instructions. <br />lcheck onel Licensed Contractor Cl Prope y Own <br />NOTE: Ihr's serl-ce rtilicdtion is only used for projects that allect the ExTERIOR of the structure. This <br />process is opplicable ONLY to ptojects where dccess to the interior of the dwelling by a Santa Ana <br />lnspector is not required. <br />Signdture:- I '(LL. LL Dote:-,1 oZ /, <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />Property Owner: <br />tr