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,-,SANTA <br />NA <br />Pt.tlilN[ <br />&IIIIJII|G <br />rct\il <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.sa nta -a na.orq <br />INSP.O2 2013 CRC <br />This document moy be found ot,,,http : //www. sa nta -a n a. o rq/p ba/ <br />(Please use a black or blue ink ball-point pen) <br />zul S Uoooeot-o <br />Permit Number:l.ottl-tolu <br />Property Owner:O*,, Auaa.Leoo <br />€uprnn Lrapc.p.^-License #: /11 lolff r L_ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and 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 />\A ro,n boxes betow must be checked: <br />Ef,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 />appl2nces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Ysmoke 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 />man ufacturer's instructions. <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: This self-certificotion is only used for projeas that olfect the EXIER/oR ol the strudure. This <br />process is applicable ONLY to projects where occess to the interior of the dwelling by a Sonta Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />Signoture:', \.3 -a Aoal <br />Project Address: <br />Contractor: <br />tr <br />Date: