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Planning & Building Agency <br />An Clvlc Conbr Phz. Rolt Annex <br />P.O. Bor lgtE (f,-l0l <br />S.ntr An., CA 92702 <br />ola) ca76E00 <br />www.aanta€na,om <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:LBzo - fr <br />Perm it Numberl <br />Property Owner: <br />contractor: ftg755rontu SAv rcgs &ur License#: ffi@g <br />rNsP{2 2013 CRC <br />rhls document mol be tound at-. htto:/ rru/w.santa-ana.oro/Dba/ <br />(Please use a black ot blue ink ball-point p€n) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Sedion R314.1and R315.2 nates in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R31.4.3.3 define <br />the required locations. <br />A *,, oo*r, below must be checked: <br />!(o*on .onoxlde 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 required in bedrooms with 8as-fired <br />appliances (i.e. hot water heater, cooktop, fumace) or a fireplace. <br />(Smoke ahrm: Are installed in 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. Comblnatlon Smol(e/CO alarms must comply wlrh all appllcable slandards and be approved <br />by the State Fire 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 monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacture/s instructions. <br />(check Licensed ontractor Property Owner <br />I{OTE: This sef<eftificotion is only used lot proirts thot olled the EXTE OR ol the structurc. This <br />process is opplicobte ONLY to ptolccts wherc occcss to thc Interiot ol the dwetling by a sonto Ano <br />tnspector B not rcqulred, <br />Signoturc:Dote <br />Have this completed form and the Job-card readily available on final inspectionl <br />?lr\\\G <br />->e