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*-SNTA <br />NA.tffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(7r4) 647.5800 <br />v/yar. s il r l:l.iln i.o re <br />rNSP-02 2013 CRC <br />This document moy be lound ot...http://un,rv. sa nta-ana.orq/pba1 <br />(Please use a black or blue ink ball-point pen) <br />il22rN. CunrE auEiluF gA^.frA Arta CA qU01 <br />Permit Number:n,t^iq()q plils.444ot <br />Property Owner:DaPIC 6RI6LEY <br />Contractor:SSF ?orrFlrle,ilr \61-^ [;,rt License #t tOUrl ArlB <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California Residentlal 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 />f\ soth 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 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. l, also, hereby certify that lwill retest the alarms per the <br />manufacturer's instructions. <br />lcheck onel Lic 5 Contractor trP ope Owner <br />NOTE: Ih,s serr-certification is only used lor projects thdt allect the EXTERIOR ol the strudure. This <br />process is applicoble ONLY to projects where dccess to the inteior of the dwelling by o Sonto Ano <br />lnspedor is not required. <br />sionoture: n. , I .l' AY-[Ub., l{h1-010t t Dote: <br />2ttl + I <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: <br />I <br />tr <br />I I