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CITI"SANM <br />NAJiiilffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(7141 647€800 <br />www.santa-ana.orq <br />|NSP42 2013 CRC <br />This document moy be found ot... http://www.santa-ana.orq/Oba/ <br />(Please use a black or blue ink balbpoint 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 R314.3.3 define <br />the required locations. <br />nBoth boxes below must be checked: <br />& C"rUon 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 />p Srof" 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 />ma n ufactu rer's ns. <br />(check onel tr cen Contractor ET Owner <br />NOTE: This seff-certificotion is only used lor projects that offea the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projeas where occess to the interior of the dwelling by a Santa Ana <br />lnspector is not required. <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:ZtZ-; (r\), l7+l1 q+ <br />Permit Number:/oll0-t-lqq <br />Property Owner:F- ey eU (ta SS <br />Contractor:ftrw,tron SurVCwe fL"F,*License #: / 0 Sq 3'T7. <br />Signoture:/tr Dote:q <br />Have this completed form and the job-card readily available on final inspection!