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**SANIA <br />NA,ffi <br />Planning & Buitding Agency <br />20 Civic Center plaza Rois An-n", <br />P.O. Box 1988 (M"19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />Smoke & CO <br />Alarm Affidavit <br />w,r'iw.santa-ana o( <br />This document may be found ot... httO //,,t,vr,v SA nta-ana.orq,/oba/ <br />(Please use a black or blue ink ba -point pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residentialbuildings <br />California Residential code (cRC) section R314.1and R315.2 states in part that existing dwellings be"retrofitted with smoke alarms and carbon monoxide alarms. CRC section R314.3 and R314.3.3 definethe req u ired locations. <br />f,\ eoth boxes betow must be checked: <br />p,c11"" monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity ofb\drooms and also on each rever of the dwellng. Alarms are required in bedrooms with gas-fired <br />lOy'liances <br />(i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Qsmote alarms: Are installed in each room used for sleeping, in each hallway outslde of a sleepingroom, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations areperformed' Combination smoke/co alarms must comply with all applicable standards and be approvedby the State Fire Marshall (SFM). Battery life must be 10 years. <br />I h ereby certify <br />that smoke alar <br />Codes and have <br />m a n ufacturer's <br />that I am the contractor or the property owner of the above project. I fu rth er certify <br />ms and carbon monoxide alarms have been installed in com pliance with the govern ing <br />been tested to be functional. l, also, hereby certify that twi ll retest the alarms per the <br />NorE: rhrs self-certification is only used for projects thot affect the ExrERloR of the structure. fhisprocess is applicable ONLY to proiects where occess to the interior of the dwelling by o santo Anolnspector is not required. <br />ru ction s. <br />(check onel icensed Con tractor o Pro p e rty Owner <br />Project Address:lru t^/1ala <br />Permit Number:lot 1 <br />Property Owner:La t/s 4 <br />Contractor:License #:Lt <br />Signoture:v Ddte:qt E <br />Have this completed form and the job-card readiry avairabre on finar inspectionl <br />rNrsP-02 2013 CRC