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,r*Srt\TA <br />A,\J.},ffi <br />P!.an,'ting & tsuiiding Agency <br />20 Civic Certir Plaza Ross Anned Smoke & CO <br />Alarm Affidavit?.O. gox 1!88 1U.19) <br />Santa A.1a, CA 92702 <br />(714) 647-5AO0 <br />fhis dDcrnent moy b9 lound at... <br />(p/eas: use a black or blua ink ball-point pen) <br />2ll L Oc 5+ <br />Pernnlt J\l uinbe r:2Dt7 oriZ <br />Propeny Owner:lQ.o ?e,r- <br />u,,."f,ch(Lic.anse #, C Sl973z 5V <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 <br />"retrofitted with smoke alarms and carbon monoxide alarms. cRC section R314.3 and R315.3 define <br />the requ ired locations. <br />f)*o boxes below musr b€ cie€k3c: <br />{c"rton r,ronoxide alarms: Are installed outside of each rleeping 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 />appPces (i. e. hot water heater, cooktop, furnace) or a fireplace. <br />Lll Srroi: ajarms: Are instalied i;r each room used for sleeping, in each hallway outside of a sieeping <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be banery-operated for buildings where no interior alterations are <br />perforrned. Combination Smoke/CO alarms must comply with all appiicable rtandards and be approved <br />by the Srate Fire Marshalt (SFM). Battery life must be 10 years. <br />I hereby certify that I am the conti'actor or the propefty owner of the above pro.ject. I fufther 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. <br />lcheck one)tr Licensed Con ti'actor A Progerty Owner <br />NorS: rhis j€f-c eiifi€rrioa is only used lor projects that affecr the EXT;-R!aR ol th.e structutr. This <br />process is apglicable 1NLY t, prcjecs where actess t, the i/,re or of the &relliag by a saard Ana <br />lnsgec'lor ii not t?quircd. <br />Have this cornpletad form and the job-card readily avail.ab{e on final insp€rtioni <br />Co ntra ctri: <br />9no5 tu z: <br />L <br />j P roject Aodrass: <br />)Dot?: ) | <br />I