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*-SANTA <br />NA.Iffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Arnex <br />P.O, Box 1988 (M-19) <br />Santa Ana. CA92702 <br />(714) 647-5800 <br />Smoke & CO <br />Alarm Affidavit <br />rNSP,02 2C13 CRC <br />This document may be lound at... <br />(Please use a black or blue ink ball.point pen) <br />Project Address: ,)il,L <br />?orl.!S €t-TtA" S(./ SA$n', F$A(44 1?,fut <br />Permit Number:lol L <br />Propertyowner: Jo*oE tvoerv@\a- i. t+tt* c|?ka <br />Contractor:gon,trl Lt fnlo^se-^License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild in gs. <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 locations, <br />f\ eoth boxes below must be checked: <br />E Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinlty of <br />bedrooms and also on each level of the dwelling, Alarms are required in bedrooms with gas-fired <br />app ances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E Smoke alarms: Are instatled 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 lwill retest the alarms per the <br />m anufacture r's instructions. <br />Signoture:Dote:B a t4 <br />lcheck onel tr Lice nsed Contractor roperty OwnerP <br />NOTE: Ihis sef- certificotion is only used for projects thot ollect the EXTERIOR ol the strudure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by o Sonto Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />J