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CMOrS ANM <br />NA-'ffi <br />, <br />?llrning & Buitding Ag"r'ry <br />20 Civic Center plaza Ross Annex <br />P.O. Box 1g8B (M-19) <br />Santa Ana, CA 92702 <br />(7 141 647-5800 <br />lvyvw. sj! nta - a n q..g rp <br />Smoke & CO <br />Alarm Affidavit <br />D <br />t <br />Project Address:7D <br />Permit Nurnber: <br />Property Owner: <br />Contractor:s3rLicense #: t <br />2013 CRC <br />This document moy be lound ot... http://wranv_.santa-ana.org/p-b-a/ <br />(P/ease use a btack or blue ink ball-point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R31.4.3.3 define <br />the required locations. <br />ff Both boxes betow must be checked: <br />pcarUon monoxide atarms: 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 />f,Fmoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />Ioo^, 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 t0 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 />(check onel tr Licensed Contractor Property Owner <br />NOTE: This seff-certificotion is only used lor projects that ollect the EXTERTOR of the structure lhis <br />process ls opplicable ONLY to projeas where occess to the interior ol the dwelling by o Sonto Ana <br />lnspedor ls not required. <br />Signature:Dote:1lr/ol"t <br />Have this completed form and the fob.card readlly avallable on flnal lnspection! <br />\r91 q1f