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*-SANTA <br />A[IA#iffi <br />Plan ning & Building Agency Smoke & CO <br />Alarm Affidavit <br />2C Civic Center Plaza Ross Annex <br />P.O. Box '1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />'.v .1 . ; t arl.:r.,r -rr? <br />This document may be Jound ot...httJ., .,,,",v)',.. Sairtr-ara.Orc, Oba <br />(p/ease use a black or blue ink ball-point pen) <br />Property Owner: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon rnonoxide alarms. CRC Section R314.3 and R315.3 define <br />the required locations. <br />A{} ll Both boxes below must be checked: <br />S Carbon monoxlde 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 />p 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 Frre Marshall (sFM). Batteri 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. <br />(check on Licensed C on tracto r tr Property owner <br />NATE: This self-eertification is only used for projects that ofled the EXTERIOR oJ the stucturc. This <br />process is applicable ONLY tc prcjeds where occess to the interior ol the dwelling by o Sdnto And <br />lnspector is not requircd. <br />Signdture: <br />Project Address:lrul f, ltn,rooJ A,r< <br />Permit Number:,/D//o2? // <br />€lzrLoil tb"Llu <br />C(c-*.Lr. License #i passz.LContractor:I <br />D ,1 z,/r.,/ze <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />l