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Planning & Building Agency <br />20 Ci.,,ic Center Pla:3 Ross Annex <br />P.O. Box 1933 (tul.19) <br />Santa Ana, CA 92702 <br />(714) 6.17.5300 <br />Smoke & CO <br />Alarm Affidavit <br />v/rr/rv,s a nta-a n a <br />ti\is2-02 2013 cRC <br />This document moy be found ot... hli3 / i,,r/\/r/\i.Santa-ana.Or o/oba,i <br />(Please use a black or blue ink batt-point pen) <br />State of Californja requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and R315.2 states in part that existing durellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the req uired locations. <br />Both boxes below must be checked: <br />Ca on monoxide alarms:Are inst3lled outside of each sleeping area in the immediate vicinity of <br />bed r <br />bom, and on each level of the dwelling <br />Retrofitted detectors may be battery-operated for buildings r,vhere no interior alterations are <br />performed. Combinaiion 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 instalied in compliance r,rrith the gorierning <br />CoCes and ha,./: been testeC <br />ap <br />lch eck onel <br />a,,a <br />tr Lic <br />ms and also on each level of the d,,,relling. Alarms are required in bedrooms r,vith gas_fired <br />ances (i.e. hot v/ater heater, cooktop, furnace) or a fireplace <br />smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />naL l , a lso , hereby certify that I will retest the alarms per the <br />manufacturer's instr ns <br />Siqnatute: <br />ctor Property Owner <br />NOTE: Ihls sef-c ertilication is only used for projects thot affect the EXTERTOR of the structure. This <br />process is applicoble olttLY to projects where access to the interior ol the dwelling by a santa Ana <br />lnspector is not required. <br />2 /2 rfl ) <br />qPermit Number: <br />Property Owner: <br />o*t'| /tl-/ to,td <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: i <br />License #:Contractor: ]