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*-SA}TA <br />NAft,ffi <br />Piann ing & ts;i;di,tg AEe.iy <br />2C Civ;c Cer'lar ?lara Ross Ar^ex <br />P.O. 8ox 1988 {M.19) <br />Sania Ana. CA 92702 <br />(7 r4) 647.s800 <br />Smoke & CO <br />Alarm Affidavit <br />lhis docu nent noy be lound ot... <br />(please use a btack ar blue ink ba -pojnf pen) <br />\L2- \ 5 )z-r,pr.oso9 <br />P a rn',l lt Number: <br />Property Owner:?--g . p S^ \r (€ Lr- <br />Co ntra ct rr:Lic ans.a #: <br />\o\qP\t\ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 requ ired locations. <br />A eo,i, boxes beJo.r must be ch,eckcd: <br />Et C"rbon n:on,cride alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Eltsmokc aJarms: Are installed in each room usad 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 csrtify 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 beq4 tested to be functional. , <br />{check oae)tr Licensed Contrart Pro ert Orlner <br />ftOTS: fh;r seil-c ertificrtion ls ool'1 used lcr pro,1'ec!s t.hot ofltct the tXfiRlER al the srtuctute. T't is <br />prccass is opplicable ONIY t, Nojecs wher? dciess tc the i/,t.rior of the dwelling by d Santd Add <br />lnspecto? is not rcquhed. <br />nl '"7\I o-1^.-.,-Dot?:rlzl tO <br />I <br />I <br />I Pro;e c{ Addrass:I <br />I <br />I s;gnature: <br />I t-I <br />H.tve this completed fcrm and the job-card readiJy avaliab{e on final ins p€ctjonr