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ANTA <br />ANA <br />P[I[t\G <br />&BilrJtr[ <br />.{ctio <br />0n0t <br />Planning & Building Agency <br />20 Civic Center Plara Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />w r'/'r'l san t3-an.t oral <br />\so 02 20 1 cRC <br />f his document moy be lound ot... <br />(Please use a black or blue ink ball-point pen) <br />Smoke & CO <br />Alarm Affidavit <br />ht:c /,,/,.,.,r. s31:a-an a.o.t :ba <br />Project Address:0 r + <br />Permit Number:() <br />Property Owner:G <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 ao,h boxes below must be checked: <br />E Carbon 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 />E 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 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 />m an ufactu rer's instructions <br />Signoture:-20 <br />(check oneJ 4.Li nsed Contracto r tr Property Ownere <br />NOTE: Ihrs sef'c ertilicotion is only used for projects thot aflect the EXTERTOR of the structure. This <br />process is opplicoble ONLY to ptojects where occess to the interior ol the dwelling by a Sonto Ano <br />intpector is not rcquired. <br />Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />-1-