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Plannlng & Building Agency <br />20 ClYlc Contor Plaza Rors Annex <br />P.O. Box 1988 (M-19) <br />Santr Ana, CA 92702 <br />(7r4) 647-5800 <br />www.sanla.itna.ora <br />Smoke & CO <br />Alarm Affidavit <br />Project Address: <br />Permlt Number: <br />gn tt) 4loucw <br />[-o [(og e2.-1 <br />L <br />Property Owner:Adu*l^O--,k\ub,o.-,-" ) <br />Contractor:Dd.,-Quo{; o a License #, 83ql e) <br />rNSP{2 2013 CRC <br />fhis document mdy bc lound ot..,http:/lr^, v.santa-ana.orq/pba/ <br />(Please use a black or blue lnk ball-polnl pon) <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 />f\ goti, boxes below must be checked: <br />{C"rbon monoide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />Sediooms 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 />FSmofe 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 />manufacture/s instructions. <br />lcheck onel Licensed ntra I Property er <br />NOTET This sef-ceftlficotioa is only used lot proiects that olied thc glrrERIOR ol the structure. lhls <br />ptor.ess is appllcoble ONLY to projeds whctc dccess to thc lntc ot ol thc dwelling by o Sonto And <br />lnspector Is not ruqulrcd. <br />Slgno/tute:Date os/rt/ tt <br />Have this completed form and the Job.card readily avallable on final inspection! <br />-,-SANTA <br />NA$[?il