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; ANIA <br />.ANAffi <br />/1' <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />Project Address:/7224-2-2- z--j; Z<-----r' <br />Permit N umber:./,/-ZVZ4Z7 <br />Property Owner: <br />(License #-/' <br />NSP-02 2011 CRC <br />fhis document moy be lound ot...h ttD //\,'/,M/i. sa n ta-a na.o ro,/Pba t <br />(Please use a black or blue ink ball-point pen) <br />State of Californla requires that smoke and caT bon 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 R314.3.3 define <br />the required locations. <br />4\ eo,l, boxes betow must be checked: <br />BQGi ^onoxide <br />alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bg)y'ooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fireci <br />es ii. e. hot water heater, cooktop, furnace) or a fireplacea <br />l_ <br />tr Sm ke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />room,nd 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 {5FM). 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 ha're been installed in cornpliance with the governing <br />Codes and have been tested to be functional. l, also, hereby certjfy that I will retest the alarms per the <br />ma n ufactu re r's instructions <br />lcheck one Licensed Contlactor tr Property Owner <br />NOTE: fh,s sef-c e rtification is only used Jor projects thot allect the EXTERIOR of the structure. This <br />process is applicable ONLY to projects where occess to the interiot of the dwelling by a Sontd And <br />lnspectot is not required. <br />Signoture Dote <br />Have this completed form and the job-card readily available on final inspection! <br />P.O. Box 1988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />vf,v., s3nt3-ana,orat <br />Contractor: