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Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />tNsP-02 2013 CRC <br />This document moy be lound ot...http://www. sa nta-a na. or qlobal <br />(Please use a black or blue ink ball-point pen) <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 R314.3,3 define <br />the requ ired locations. <br />A eoah boxes below must be checked: <br />J4 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 />psmoke 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 a nufacturer's instructions. <br />lcheck onel Lic nsed Contractor Property Owner <br />NOf E: This self-certificotion is only used for prcjects thot alfect the ExTERtoR ol the structure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by o Sonta And <br />lnspector is not required. <br />Project Address:8t8 €,t?l\ st <br />Permit Number:1t\t I btLlt <br />Property Owner:nnis OG.reron <br />Contractor:Ofo.rv. 6*Jy Y2#^n lti.""'e *1gl [77 <br />Signoture:I hq Dote:7 ,t0 .11 <br />Have this completed form and the job-card readily available on final inspection! <br />,*,,SANTA <br />NA-',f,ffi <br />P.O. Box 1988 (M.'19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />wwrrv. Sa nta-ana.orq <br />o