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Pla n ning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (tu1-l9) <br />Santa Ana, CA 92702 <br />(714l, 647-5800 <br />'rl' .3enla-ana ota) <br />n]sP,02 2013 CRC <br />Project Address: <br />Permit Number: <br />OA 3l.a rr{,Lr <br />icense #:q73$t <br />State of Ca lifornia requires that smoke and carbon monoxide (Co) alarms are installed in residential <br />b u 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 R314.3.3 define <br />the req u ired locations. <br />fi eo,tr boxes below must be checked: <br />fuC"rionmonoxide 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 />i-z <br />A{ 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. I, also, hereby certify that I will retest the alarms per the <br />m a n ufacturer's instruction s. <br />lcheck onel Licen sed Contractor rop rty Owner <br />NOTE: Ihls self'certification is only used for projects that offect the EXTERIOR ol the structure. This <br />process is opplieable ONLY to projects where occess to the interior of the dwetling by a Santo Ano <br />lnspector is not required. <br />trP <br />*a A <br />Property Owner: <br />Contractor:rhr <br />Sig n otu re:Dote: <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />This document may be |ound dt... http //,,,,",,i,,y santa-ana orq,rocal <br />(Please use a black or blue ink ball-point pen) <br />\\(LAA\ <br />Z _)