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*,,SNTA <br />NA#ilH <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />fhis document moy be lound ot...http://un,vr.santa-ana.or olobat <br />(Please use a black or blue ink ball-point pen) <br />Project Address:I ^) Nq,u <br />2.0 t1 LA{ SPermit Number: <br />Property Owner:i*uz,t pt_ar", <br />Contractor:Anl Altcrnahres License #:&"ls 33 <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 />4\ eo,l, boxes below must be checked: <br />Hc"rbon 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 />{Smote 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 Licensed Contractor Property Owner <br />NOTE: Ihis serr-certificotion is only used for projects thot dflect the EXTERIOR ol the structure, This <br />prccess is opplicoble ONLY to ptojects whete occess to the interior oI the dwelling by o Sdnta Ano <br />lnspedot is not rcquircd, <br />Signoture:Dote:}Jur r r\ <br />Have this completed form and the iob-card readily available on final inspection! <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />w!\ry/. sa nti -a n il. orq <br />rNSP-02 2013 CRC <br />tr