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;-$AI{TA <br />NA,ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P,O. Box 1 988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />w'r'rr.s 3n ta-an a. or0 <br />hrsP-02 2013 cRC <br />This document may be lound at...h ttO.//,,'r,,r',,i. sa n ta -a na.o aq,tA'aa,t <br />(Please use a black or blue ink ball-point pen) <br />State of California requires that smoke and arbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <br />California ResidentlalCode (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 req u ired locations. <br />f\ ao,h boxes betow must be checked: <br />/%lrArnmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of' bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />ap liances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />o e 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 alt 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 Boverning <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />m a n ufacturer's instructions. <br />(check onel 5e Contracto r P o perty Owner <br />NoTE: Ihrs sef-certificotion is only used for projects thot offect the EXTERtoR of the structure. This <br />process is applicoble ONLY to projects where occess to the interior of the dwelling by o Sonta Ano <br />lnspector is not required. <br />Project Address: <br />Permit Number: <br />Property Owner:1.-.-.- <br />Contractor:License #:? <br />Signdture: <br />Have this completed form and the job-card readily available on final inspection! <br />7"& €- ./,----t--4.-z <- <br />tr