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,-*SA\TA <br />,{]\.t,h,ffi <br />Pl.an,ting & ts,ti;oi;t g Age-t:y <br />20 Ci\/rc Certer plara Rcss a^ne,Smoke & CO <br />Alarm AffidavitP.O. B€x ! 988 {M-19) <br />Sadta Ana, CA 92702 <br />(7r4) 647.5800 <br />tkis docu rnent may b,e lould ot... <br />fpleass use a bla,ck or blue ink ball-point Pen) <br />75q <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <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 required locations. <br />Bot,ar boxas below rnust be check3d: <br />Carbofl r,ron'oxide atrarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each ievel of the d\,ve{ling. Alarms are recommended in bedrooms with gas-fired <br />app/fnces (i. e. hot water heater, cooktop, fumace) or a fireplace. <br />El Sn':oke ajarms: Are instalied in each room r.rsed for sleeping, in each hallway outs;de 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). Banery life must be L0 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. <br />{check one)ontractor E Property Owner <br />ltiorE: rhrs se,f-c ef.ific.rtioa is only used lor glojects that sffect thz txriRE,R ol tjre struciufe. This <br />p(ocess is applicable 1NLY to projects wrlerg sccess to the iateior of th e dw.etliag by a iosra Afio <br />lnspettar is not rcquired. <br />HavE this completed form and the job-card readily availab{e on final inspe€tionl <br />Proje.ct Add,rass: <br />Permit N uinbe r: <br />Property Owner:Lnper"i",&<rrrr, <br />Contractcr:(d \G/cekzq-ttLic,anse #: <br />Signotu(e:Dot?:l- 2fi -20 <br />E <br />o 20t 0 <br />Z 7rn