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,,-SNH <br />AtrfA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />,'r --/. s l.r:l-1_,l 1rr <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:z-a3 | Fr.*.L. S{. <br />Permit Number:/Drl o zq lD <br />Property Owner:)-",,I ?o;c\ <br />(please use a black or blue ink ball-point pen) <br />fhis document mqy be found at...D,,/',,i,/,/,.Saitt_i-an3.OrC 0:.i <br />tCe License #:s7lto3 <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 R3L4.1and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R31.5.3 define <br />the req u ired locations. <br />/A# B Both boxes below must be checked: <br />S Carbon monoxide atarms: 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 />psmote 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 Fri'e Marshall (SFM). Batteri 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. <br />? <br />(check one tr'Lice nsed Contracto r E roperty owner <br />NCTE: Ills sef-c ertification is only used for prcjecB thdt oflect the EXTERIOR ol the studurc. This <br />process is opplicable ONLY to projeds where dccess to the interior al the dwelling by o Sonta Ana <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />l <br />Contractor: <br />I Signature:Ddte: <br />I