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,-,SANTA <br />NA,Iffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.'19) <br />Santa Ana, CA 92702 <br />(71.1) 647-s800 <br />AA/,;Irl) rriI -,. l <br />Smoke & CO <br />Alarm Affidavit <br />i'lr'r. SantS-lna OrO Dba <br />(prease 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 R315.3 define <br />the requ ired locations. <br />A so,tr 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />El 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 lam the contractor or the property owner of the above project. lfurther certify <br />that smoke alarms and bon monoxide alarms have been installed in compliance with the governing <br />Codes and have nte dtobe cti nal <br />(check onel License ont ctor Property Owner <br />NOTE: fh,s serf-c ertilicotion is only used lot projects th(,t allect the EXTER//OR ol the structute. This <br />process is applicoble ONLY to projeds where occess to the inte or of the dwelling by o Sonta Ano <br />lnspedor is not tequired. <br />Project Address:2Sq5 lc, rnrrr, D 2 {b,-*,| (4q)? <br />Permit Number:9Y; t[r37]l <br />Property Owner:)OF hr'rcza/r'z <br />Contractor:lvlr/,.ro License *, 'l tSe V t <br />Signature:r N__.-Dote 47fr t1 <br />Have this completed form and the job-card readily available on final inspection! <br />fhis document may be lound ot... <br />II