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lNsP-0? 2c 13 cRc <br />This document mqy be lound qt... h l:tc:/ '/r/'r!y. sa n ta -a na.orqr pba, <br />(P/ease use a black or blue ink ball-point pen) <br />*,SA}I'IA <br />NAffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA 92702 <br />(714) 647.s800 <br />wwirv santa-ana.Olq <br />Smoke & CO <br />Alarm Affidavit <br />Project Address: 3 :-L I V.Joo <br />Permit N umber: <br />Property Owner: <br />C o ntract or:License #: <br />State of California requires that smoke and carbon monoxide {CO) alarms are installed in residential <br />bu ild in gs. <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 loca tions. <br />A eo,h boxes below must be checked: <br />Z Carbon monoxide alarms: Are instalted 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 />EI Smoke 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 ba tte ry-o pera ted for bu ildings where no interior alterations are <br />performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved <br />by the St3te Fire Marshall (SFM). Battery life must be 10 years. <br />I hereby certif/ 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 certjfy that I will retest the alarms per the <br />ctions <br />Signdture: <br />C <br />manufacturer's ins <br />lcheck one)tr en sed Con ti'actor tr P ro perty Owner <br />NOTE: rh,s sef-c eftification is only used lor projects thot olfect the ExTERtoR ol the structure. This <br />process is applicable ONLY to prcjects where occess to the interior of the dwelling by d Sontd Ano <br />lnspector is not tequited. <br />Have this completed form and the job-card readily available on final inspection! <br />Dote: 9 <br />l <br />I <br />lc.^A ?l