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CITI"SANM <br />NAJ[{il[ <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />santa Ana, cA 92702 <br />(t141647-5800 <br />www.santa-ana.orq <br />Smoke & GO <br />Alarm Affidavit <br />This document may be fuund at... htto://www.santa-ana.oro/oba/ <br />(Plase use a btack or blue ink 0rill-ptnt pen) <br />Project Address:2101 Barc\aY Lr+ <br />Permit Number:l0 \\0vLL+3 <br />Property Owner:'t}8eet 0harler R.ob rnsoi,.. <br />Contractor:Vrvrn| So\ar License#:1lA15O <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 />Aaoth boxes below must be checked: <br />EI Carbon 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 />El Smote alarms: Are installed in each room used for sleeping, in each haltway 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 instructions. <br />(check onel Contractor Property <br />NOTE: This self-certiftcotion is only used for proieas thot offed the HfiERIOR of the structure. This <br />process is opplicoble ONLY to prolects where occess to the interior of the dwelllng by a Sonta Ano <br />lnspector is not required. <br />&Signoture:,orr Lo9t r*L( <br />Have this completed form and the iob-card readily available on final inspectionl