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CITI"SANM
NAJ[{il[
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-19)
santa Ana, cA 92702
(t141647-5800
www.santa-ana.orq
Smoke & GO
Alarm Affidavit
This document may be fuund at... htto://www.santa-ana.oro/oba/
(Plase use a btack or blue ink 0rill-ptnt pen)
Project Address:2101 Barc\aY Lr+
Permit Number:l0 \\0vLL+3
Property Owner:'t}8eet 0harler R.ob rnsoi,..
Contractor:Vrvrn| So\ar License#:1lA15O
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
buildings.
California Residential Code (CRC) Section R314.1 and R315.2 states in part that existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define
the required locations.
Aaoth boxes below must be checked:
EI Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
El Smote alarms: Are installed in each room used for sleeping, in each haltway outside of a sleeping
room, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no interior alterations are
performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved
by the State Fire Marshall (SFM). Battery life must be 10 years.
I hereby certify that I am the contractor or the property owner of the above project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the
ma n ufactu rer's instructions.
(check onel Contractor Property
NOTE: This self-certiftcotion is only used for proieas thot offed the HfiERIOR of the structure. This
process is opplicoble ONLY to prolects where occess to the interior of the dwelllng by a Sonta Ano
lnspector is not required.
&Signoture:,orr Lo9t r*L(
Have this completed form and the iob-card readily available on final inspectionl