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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (lu-'|9) <br />Santa Ana. CA 92702 <br />(714) 647-5800 <br />y/,/a// sania-aaa cru <br />Smoke & CO <br />Alarm Affidavit <br />ll'/SP-02 2013 CRC <br />This document moy be Jound at... h::3.' ,', ,,. ,', . S ?: i ? - 3.1 i <br />(Please use a black or blue ink ball-point pen) <br />Project Address: <br />orqroba' <br />Permit Number: <br />Property Owner: <br />Contractor: <br />I hereby certify that I am the con <br />that smoke alarms and carbon m <br />Codes and have been tested to b <br />manufacturer's instructions. <br />(check onel O- Licensed Contractor <br />icense #:>6 <br />a-- Property owner <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 R315.2 states in part that existing dwellings be"retrofitted urith smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />-::,-.t,-,;, .i Both boxes below must be checked: <br />ffcarbon 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 />E6moke 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 areperformed. 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 />tractor or the property owner of the above project. I further certify <br />onoxide alarms have been installed in compliance with the governing <br />e functional. l, also, her.eby certify that I will retest the alarms per the <br />fu4,{> <br />NorE: This self-certificotion is only used Jor projects thdt olfect the EXTER]7R ol the structure. Thisprocess is opplicoble 0NLY to proiects where occess to the interiot oI the dwelting by d sdnta Ano <br />!nspector is not required. <br />Have this completed form and the job-card readily available on final inspectionl <br />Signoture:Ddte: <br />-1-ct2-- zs <br />fr>