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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P,O. Box '1988 (Ml9) <br />Santa Ana, CA92702 <br />(714) 647.5800 <br />v/.//,//. s a n ta- a n a. o rcl <br />]NSP.O2 2013 CRC <br />This document moy be found at.. <br />Smoke & CO <br />Alarm Affidavit <br />h tto:/,',r,,r1. sant a-ane.or o'oba' <br />(Please use a black or blue ink ball-point pen) <br />h \ <br />Property Owner: <br />Contractor: <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 R314.1 and R 315.2 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 req u ired location s. <br />fr eo,r, boxes below must be checked: <br />I 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 />!y' 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 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 lwitl retest the alarms per the <br />m a n ufactur r's instructions. <br />(check onel X Licensed Contracto r Property Owner <br />NOTE: This self-certificotion is only used for prcjects thot aflect the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelting by a Sonta Ana <br />lnspector is not required. <br />fProject Address: <br />Permit Number: <br />C<C'License #, Ll .fO <br />rr <br />Signoture:Dote:L- L* -z -o <br />Have this completed form and the job-card readily available on final inspection!