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*,SNTA <br />NA'ffi <br />Or f * leO <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa.ana.orq <br />.tNsP-02 2013 CRC <br />This document may be lound at.http: //www. sa n ta-ana.oislBbai <br />(Please use a black or blue ink ball-point pen) <br />Ler Sa.lo* qr"6. AnrollPermit Number: <br />Property Owner:?oqqq Aonznkl <br />Contractor: <br />- llicense #: 1Z3.lOa <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 required Iocations. <br />4\eoth boxes betow must be checked: <br />MC.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 />applj;nces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />EI Smoke alarms: Are instalted 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 rnust 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 />ma nufactu rer's instructions. <br />(check onel Licensed ontractor Property Owner <br />NOTE: Ihrs sef-certificotion is only used for projects thot offect the EXTERIoR of the structure. This <br />process is opplicable ONLY to projects where access to the interior oI the dwelling by a Santd Ano <br />lnspector is not required. <br />,r//)Signdture:,<-) <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I <br />I <br />1 <br />Project Address: <br />II <br />I <br />I <br />I <br />I <br />oote: <br />I