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A1\n <br />I <br />'\6 <br />,r *.Dl\C <br />$no <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana. CA92702 <br />(714) 647-s800 <br />nta-ana or <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-02 2013 CRC <br />This document may be lound at...htto./ ),r,,i,,/. sa nta -a n a. o.q'cba <br />(Please use a black or blue ink ball-point pen) <br />Permit Number:t0ll <br />Ua <br />Contractor:License #:001 <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 R314.1 and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the requ ired locations. <br />A eo,h boxes below must be checked: <br />Elcarbon 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 />6S.ot" 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 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 />man ufactu rer's instructions. <br />lcheck onel Licensed Contracto r tr Property Owner <br />N9TE: This self'certificotion is only used for projects thot olfect the ExrERrcR ol the structure. This <br />process is opplicable ONLY to projects where occess to the interior ol the dwelling by o Santo Ano <br />lnspector is not required. <br />Il <br />Project Address:II\, <br />Property Owner: <br />Signoture:Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />f- <br />tr