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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, CA 92702 <br />(714) 647-5800 <br />na.orq <br />INSP.O2 2013 CRC <br />This document moy be found at...htto:/iwww.sa nta-an a.orql obal <br />(Please use a black or blue ink ball-point pen) <br />Project Address: <br />t o //o77aOPermit Number: <br />Property Owner:LY <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 R31.4.3 and R314.3.3 define <br />the requ ired locations. <br />6\eoti, 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 governtng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />ma nufactu rer's instructions. <br />(check onel tr Pro erty Owner <br />NOTE: rhrs sef-c ertiJication is only used fot projects thot dffect the ExTERtoR of the structure. This <br />process is applicoble ONLY to projects where access to the interior ol the dwetting by o Sdnta Ana <br />lnspector is not required. <br />Signoture:a Ddte:lqt 70 <br />Have this completed form and the job-card readily available on final inspection! <br />*,,SANTA <br />NA/}ffi <br />Licensed Contractor