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O"'SANIA <br />NATffi <br />Planning & Building Agency <br />20 Civrc Caata. Plaza Ross Annex <br />P.O. Box 1988 {M.19) <br />Santa Axa, CA 92702 <br />(714) 547.5800 <br />Smoke & CO <br />Alarm Affidavit <br />f his docuneat mo,J be lound ot... <br />(p/ease use a black or blue ink ball-paln! pen) <br />Pro;ect ACdress:3q,LL S.--[raBrra- <br />Permit Humber:\o)3?68L <br />Property Owner:&nruSO- Je-,,-\A <br />Licanse #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R315.3 define <br />the requ ired locations. <br />{)a"',;boxes beiow musr be checked: <br />E.€arbon monoride 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 recommended in bedrooms with gasjired <br />apfances (i. e, hot water heater, cooktop, furnace) or a fireplace. <br />El Smot: a)arms: Are installed in each room used for sleeping, in each hallway outside of a sleeprng <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 (5FM). 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 be n tested to be functionai <br />lcheck onel tr Licensed tractor <br />ttiOTE: Ihis sef-cedificotion is only used lor projeds thot al|ect the EXTER|OR ol the sttuctute. This <br />p@cess is opplicable ONLY to projeds wherc dccess to the iateiot ol the dwelling by a Sontd Ano <br />ldspectot is not required. <br />Have this cornpleted form and the job-card read)ly available on final inspectionl <br />,|Signdtute:lo-/Br8 <br />Contiacter: <br />Property Owner <br />Yfrn J Dale: