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*-SNTA <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Bor 1988 (ir-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />11 i..'.',.sintil.3f'r;t.arcl <br />Smoke & CO <br />AIarm Affidavit <br />rNSP-02 2013 CRC <br />This document moy be lound dt...http://,rn,.rr,santa-a na.oro/pbal <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 />b u 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 />{l I eoth boxes below must be checked: <br />lpcarbon 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 />psmoke atarms: 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 ctional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instruction <br />lcheck onel tr Licensed cont or P rop ner <br />NOTE: Ihis sef-certificotion is only used for projeas thot ofled the EXTERIOR of the sttucture. This <br />process is opplicoble ONLY to projects where occess to the interiot oI the dwelling by o Sonta Ano <br />lnspector is not tequired. <br />Project Address:.t l(, <br />Permit Number: <br />OC <br />21 <br />!) (- <br />vor(ot?q6 <br />Property Owner:AAtot xae-*S'oAlzEz <br />Contractor:5u,rutesl %o i 4gr'/(,License #: <br />Signotute:x_(7 Ddte:L 5/ <br />Have this completed form and the job-card readily available on final inspectionl <br />I