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*-SNTA <br />NAJffi <br />PianninE & tsuilding Ag?ncy <br />2C Ci/c Cecte.. Plata Ross,q.ne{ <br />P.O. Box 1988 (U.19) <br />Santa A,1a, CA 92702 <br />(7't4) 647.5E00 <br />Smoke & CO <br />Alarm Affidavit <br />Project Addrass:l'7 s <br />Pe rrnlt N uinber:to q <br />Prop€rty O..i/ner:vts <br />Co ntra ct l i;Lic ars.e #: <br />this documefit moy be lound at-.. <br />(pleas.e use a black or blue i.nk bafi-point pen) <br />J-\ e"ti boxes b€tow must be checkEd: <br />I <br />E Ca,'bon rnon,oxid,3 alarms: Are installed outside of each sleeping area ln the immediate vicinity of <br />be/rooms and also on each level of the d\ivelling. Alarms are recommended in bedrooms with gas-fired <br />a?Fliances (i. e. hot water heater, cooktop, furnace) or a fireplace. <br />d Smok: alarms: Are installed in each room used for sleeping, in each hallway outs;de of a steeping <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). Eattery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. I fudher certify <br />that smoke alarms and carbon monoxide alarms have been lnstalled in compliance with the governing <br />Codes and have b ested to be fu nctional. <br />{check one L lc 5e Con tractor tr Property er <br />!iOTE: rh.ri sei/-c ertificatioa is oaly used lcr grojecis that dll?ct the €xlF-Rlof, of th.e strucruie. This <br />pocets is opplicable ONLY to projeds where cccess to the inteiot of the d*elling by a Santa Ana <br />lnspecto? is not requiEd. <br />/t5ignaturz: <br />H.ave this completed fcrm and the job-card readily availab,{e on final ins pectio,n! <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 />I <br />Ddt?: