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**$Ail.TA <br />A}{Affi <br />2C Civic Center Plaza Rcss Annex <br />Plan ning & Building Agency Smoke & CO <br />Alarm AffidavitP O. Bor '19E8 (lvl-19) <br />Senta Ana. CA 92702 <br />(714) 647.5400 <br />i^/ & <br />^/ <br />sl^ir-a.I..-l <br />rNSP-02 2! l] ;RC <br />This document moy be found qt <br />(Please use a black or blue ink ball-point pen) <br />i.rrl,\,!v S3li3-?i'li C <br />Permit Number: I 0 <br />Property Ownei': l <br />Contractor: <br />v4 <br />/'r O-,1 i a- L <br />o <br />,Rao <br />/".. <br />Lice nse #ot L <br />State of California requires that smoke and carbon monoxjde (CO) alarms are installed in residential <br />b u ild in gs. <br />California Residential Code (CRC) Section R314.1. and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and cai'bon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />A eoti, boxes below must be checked: <br />(CrrUon monoxide aiarms: Are installed outside of each sleeping area in the immedrale 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 />D{:moke alarms: Are installed in each rcom used for sleeping, in eacn hallway oLtside of a steeping <br />room, and on each level of the dwelling <br />Reti'ofitted detectors may be battery'operated for buildings where no interior alterations are <br />performed. Combinatjon Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire IVlarshall (5FM). 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 monoxjde 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 />manufacturer's instructions, <br />Signoture:Ddte: <br />lcheck one)Llcensed Co ntractor Prope Owner <br />NOTE: Ihls sef-c ertificotion is only used for projects thot aflect the EXTERIOR ol the structure. This <br />process is applicable ONLY to proiects where access to the interior of the dwelling by a Santa And <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspectionl <br />Project Add ress: <br />tr