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*,,SANTA <br />NAffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Ptaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />v/!./r.sintt.ani orq <br />tNsP-02 2013 CRC <br />This document moy be found at..,http://\,,,,u/.santa-ana.orq/pbai <br />(Prease use a black or blue ink ball-point pen) <br />Project Address:, (\ <br />Property Owner:I<arqa(( ?*-,a.a,ao <br />Contractor:I 0.1 elc-fi.License *: e]51<{ 8L <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California ResidentialCode (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\ eoth 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 I will retest the alarms per the <br />manufacturer's instructions. <br />leheck onel tr tce n se d Contractor Property Owner <br />NOIt: This seff-certificotion is only used for projects thot allect the EXTERIOR ol the structute. This <br />process is opplicdble oNLY to ptojeds where occess to the inte or of the dwelling by o Santd Ano <br />lnspector is not rcquired. <br />Signature:Dote 317 /u <br />Have this completed form and the job-card readily available on final inspection! <br />so <br />Permit Number:S'V <br />I