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Planning & Building Agency <br />2C Givic Cente!'Piaza Rcss A.r:ex <br />P.O. Box 1938 (M-19) <br />Sanr.a Ana, CA927a2 <br />(71,r) 647-5800 <br />,\r'r'l.santa.alla ori <br />Smoke & CO <br />Alarm Affidavit <br />r\s?-c2 2c'3 0?l <br />This document moy be found dt... <br />(Please use a black or blue ink ball-point pen) <br />Project Address:20qo a"jc-il-, <br />Permit Number to tEbae? <br />nhutqNProperty Owner: <br />Contractor:-W)+License #,WtrpA <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1 and R315.2 states in part that eiisting dwelllngs be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />Aao,h boxes below must be checked: <br />E Carbon monoxide 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 gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />E Smoke alarms: 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. 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 certify that I am the co or the property owner of the above project. I further certify <br />that smoke alarms and ca xide alarms have been installed in compliance with the governing <br />Codes and have been e fu nctiona l. I , also, hereby certify that I will retest the alarms per the <br />man ufacture r's in <br />(check one censed Contractor Property Owner <br />NOTE: Ihis sef-certificotion is only used for projects thot olfect the EXTERIOR ol the structure. This <br />process is applicoble ONLY to projeds where occess to the interior of the dwelling by a Santa Ana <br />lnspector is not required, <br />Signdture:Dote <br />Have this completed torm and the job-card readily available on final inspectionl <br />*-SANTA <br />NA,Hffi <br />tr