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*-SNTA <br />ruwtc <br />tsrlJm <br />Smoke & CO <br />AIarm Affidavit <br />rNSP-02 2013 CRC <br />,r',',',r. s3ai.t-:ni l.:i <br />(Please use a btacl< or blue ink bal!-point pen) <br />Project Ad d ress:Laur<J :r l <br />Permit Number:i 10il0 30 q3 <br />P roperty Owner:LaurA-WI <br />Contractor:License #:6tl <br />State of CaliforniJ require! that smoke and carbon monorjde (CO) alarms are in;talled in re:id:ntial <br />b uildings. <br />California Residential Code (CRC) section R314.1and R315.2 states in part that existing dwellings be"retrofitted with smoke alarms and carbon monoxide alarms, cRc section R314,3 and R314.3.3 define <br />the required Jocatjons. <br />.f\ aorh boxes betow must be checked: <br />rbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />oms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />nces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />bed ro <br />applia <br />rbrnote aiarms: Are installed jn 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 certiiy that I an'l the contractor or the property owrier of the above project. I further cenify <br />that smoke alarms and carb,on monoxide alarms have been installed in cor,npliance with the governmg <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />manufacturer's instructions. <br />:R t IC <br />lcheck onel tr licensed Contractoi P ropertY Owner <br />NoTE: This self'certilicdtion is only used for projects that offect the EXTERrcR of the structure. This <br />process is applicable oNLy to ptoiects where access to the interior ol the dwetting by o santd And <br />lnspector is not required. <br />Signdture:(/" , -\{.! c-rn,( <br />Have this completed form and the job-card readiry avairabre on final inspection! <br />Planning & Building Agency <br />?0 Ciyic Center Plara Ross Annex <br />P.O. Box 19&3 (M-19) <br />Santa Ana, CA 92702 <br />(,714) 647-540a <br />/i'r,./. sa t::t-t.1t o.l <br />This document may be found at.,. <br />Dote: