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-,-SAI\[IA <br />NA <br />ILtw\c <br />.ilutDn[ <br />ICI\II <br />l@ning & Buitding Agency <br />20 Civic CBflt6r Plaza Ross Anner <br />P.O. Box 19EB (M.19) <br />Santa Ana. CA 92702 <br />(714) 647.5600 <br />Smoke & CO <br />Alarm Affidavit <br />:i )r'! -- <br />This document mdy be found ot.,.n:i:!, ,ir ::1 '-:1-:. i <br />(please use a black or blue ink ball-polnt pen) <br />5 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California Residential Code (CRC) Section R314,1and R315.2 states in part that existing dwellings be"retrofitted with smoke alarms and carbon monoxide alarms. CRc section R314.3 and R315.3 define <br />the required locations. <br />fleo,t boxes betow musr be checked: <br />prgarbon 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />flS^o("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 ce rtify <br />that smoke alar <br />that I am the contractor or the property owner of the above project. I further certify <br />ms and carbon monoxide alarms have been installed in compliance with the governing <br />been tested to be functional.Codes an <br />Z1 <br />lcheck one)tr icensed Contractor P rty ner <br />NorE: rhis sef-c ertification is only used for proleas thot ofJect the EXTER!1R ol the structwe. This <br />process is applicoble aNLY to ptolects where access to the inte or ol the dwelting by a sonta And <br />lnspector it not required. <br />Project Address: <br />Permit Number:/ 71 33-7 <br />Property Owner:o <br />Contractor:n/t o/ttw License#r b /32X. <br />Signature:\$^l-0_.Date:s/ <br />Have this completed form and the job-card readily available on linal inspectionl