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**SNIA <br />NA,ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA92702 <br />(714) 647-s800 <br />www. san ta-a n a. orq <br />tNSP-02 2013 CRC <br />This document mdy be found at...htto://www. sa nta-a na orqlobal <br />(P/ease use a black or blue ink balbpoint pen) <br />Project Address:5 5/ <br />Permit Number:lon?3c6 <br />Property Owner:d- <br />Contractor:R.rl R.ocrC;nS trLc liclnse#, loo134s <br />State of California requires that smoke and carbon monoxide (Co) alarms are installed in residential <br />b u ild in gs. <br />California Residential Code (CRC) Section R31.4.1 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 required location s. <br />A aotl, 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 />manufacturer's instructions. <br />lcheck onel B Lic sed tractor tr P roperty Owner <br />NOTE: Ihis sef-certificotion is only used for prcjects thot ollect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior of the dwelling by o Santd Ano <br />lnspector is not tequired. <br />Dote:l,s/so/tl <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />Signoture: <br />I