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Planalng & Butdn! Agcncy
<br />20 ClYtc Ca .t PJrE Ror3 Anart
<br />P.O. Eor ,96! ltt-19)
<br />Sarra Aoa, Cl 0?70?
<br />(7r4) 6t7.5a0'
<br />'a'rt totl,r,int Oro
<br />Smoke & CO
<br />Alarm Affidavit
<br />rhit dotuta?ln moy bc lound oc-,. .Ll!S j:-,v4&/.*!-lg* AW-2,3.EJ}|
<br />(Pleat. u* e bbc* ot blrln !* br -fE,int !,in)
<br />Propct Addrers:
<br />Permlt t{umber '. dta/ ?D yls
<br />.!rrcorxle:$- F \o,l -l'- fli,c-,ftJrr
<br />License #:
<br />State ol Calitornra tequirei thit smoke and (arbon mofiorlde 1C0) ai,rirns are ,.3laii:c .- "2: ir.a .
<br />building5.
<br />Calfornia Resideotral Code{CRC)sectionfl3l:t1andR31S25ldtesrnpa.?tt3terJ:,,:gc,'.e.gi:n
<br />"relro{rtted i,vrth smob ahr.ns and carbon monoxid€ alarmi. cffc sect,or R314 J and R3i.t 3 3 d!:t.ie
<br />the required locationr.
<br />A* **, b.bw nust b. ch.*rd:
<br />tsrfattoar -orrotld! aLmts: Are installed outsrde of lach sleeping arei rn the lmmpdiatp y,c.n,r; ot
<br />bedrooru and also on each ,evel of the dwellrng. AIa(m9 are reqqlred rn o?d.ooilri ,v,iD gal.rr.eJ
<br />appliancet (i.e hol water heater, (oottop. furnace) or a f;reptace.
<br />dsmole rlarnrs: Are installed in eaah room uscd for sieeping, rn each ha,hd-ay orl,,do oi a riefp.^d
<br />room, and on each level o, the dwelllfl8.
<br />Retrofittcd detertors may be battery-operated for burldlngg wh€re no rnteior altera!rons a.e
<br />pertortned. Cornbinatlon Smoke/CO alarms must compl! wrth all apDhcabl€ gtaodardl ,nd oe dpsre,,rc
<br />by the State Iire Ma6hall {sfM). Balt.ry life rnust be 10 yearr.
<br />I hereby ertify that I am the contractor or the property owner of the ailove prorect I turther cen,ry
<br />that smote rlarmg and carbon monoxide alarms haya been rGstalled in complian(e wrth the goeer'3.ig
<br />Codet and have been tested to be funattonil l, a,so, he(eby certtf/ thJt I w'ii retest :he i:ar!]1s pcr i're
<br />manufacture/s inrtructions.
<br />Dole:tuta:Signo
<br />{che* ont
<br />*slklLr--__
<br />PropPrty C^o€'Lr(ensed Cont(a(tor
<br />NOIE: fhis s2$aertifcotiot is ooty used lu ptoicc$ tha, alred ihc FXfEAtOn ol he srrucrure- th;t
<br />pre.es is opgllcablc ON|Y ro proiccts shere .ccass to *tc intcri,,r ol thc dvretlit E by o Soaao Ana
<br />tns,€'ctot It noa rcqukcd.
<br />Havo this completod lorm and the job-card raadily available on final insp.clioni
<br />,-,,SAITA
<br />,{ll'r*
<br />Pon.r- ,\
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