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*,SANIA <br />ANAffi <br />Planning & Building Ag+ncy <br />20 Civic Center PlazJ Ross Anne.r <br />P.O Bor l lAa (M-13) <br />Santa Ana. CA 92702 <br />(7 u) 6.17.5A00,,,,;1- r'r'l: : <br />Smoke & CO <br />Alarm Affidavit <br />fhis document mdy be lound ot... <br />(please use a black or blue ink ball-point pen) <br />Project Address: <br />I <br />3l <br />,)t) <br />Permit N umber: <br />Property Owner: <br />i <br />Contractor <br />C a <br />w 6/ <br />Signature: - .--t Dot z: <br />lcheck one)tr Lice n sed Con tractor Prop ner(ly <br />NOIE: Ihls sef-c ertificdtion is only used lor prcjects thdt dffect the EXTERTOR of the sttucture. fhis <br />process is applicoble ONLY to projects where access to the interior of the dvvelling by d Sonlc And <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspectionl <br />UJ <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 R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted r,rith smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R315.3 def ine <br />the required locations. <br />f\ eo,h boxes betow must be checked: <br />E Carbon monoxide atarms: Are initilled outside of each sleeping are3 in the immediate vicinity ot <br />bedrooms and also on e:ch level of tne dwelling. Alarms are recommended jn bedrooms witn gai-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E Smoke alarms: Are inst3lled in e:ch 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 appro,red <br />by the State Flre 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 mo,gonde alarms have been inst3lled in compliance with the governing <br />Codes and have been 66sted to be\unctional.