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*,SANTA <br />NA,'iffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(711) 647-5800 <br />wwY/.s n nta-an a.o rq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document mdy be found dt... <br />(Please use a black or blue ink <br />http:/irm.nv.santa-ana.orq/Pba/ <br />int <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu 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 requ ired locations. <br />6\ eoth boxes below must be checked: <br />Etarbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />6edrooms 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 />5mo alarms: Are installed in each room used for sleeping, in each hallway outside of a sleepinB <br />om, 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. lfurther 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 />(check onel Lic sed Con tor Property Owner <br />NOTE: Ihis sef-certificotion is only used for prcjects thdt dlled the EXTERIOR oI the strudure. This <br />process is opplicdble ONLY to projects where occess to the intetiot ol the dwelling by a Sonta Ana <br />lnspector is not required. <br />Project Address: <br />Permit Number: <br />lll t 5 Bt <br />zo t1 z1{/ <br />Property Owner:Q-,Afi <br />Contractor:License #: <br />Signature:Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />/.t <br />I <br />z- <br />tr <br />)l z,Z