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Planning & Building Agency <br />20 Civic Center Plaza Ross Annex Smoke & CO <br />Alarm Affidavit <br />r.lsP-022!13CPC <br />This document may be found at.-.h ttO.//,,'r.,,r',,r sa nta -a n a.o rq,tobal <br />(Please use a black or blue ink ba -point pen) <br />Project Address:l-Lz': . e<j-\e-'Dr - <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 R314.1 and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Sectlon R314.3 and R314.3.3 define <br />the req u ired locations. <br />f,l ro,n boxes betow must be checked: <br />M.arbonmonoxide 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 />d^of"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 b atte ry-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, l, also, hereby certify that I will retest the alarms per the <br />ma n ufacturer's in structions. <br />(check onel tr Licensed Cont racto r tr Pro erty Owner <br />NoTE: rhrs sef-c ertificdtion is only used for projects thot dflect the ExTERtoR ol the structute. This <br />process is dpplicoble ONLY to projects where occess to the interior ol the dwelling by o Santo Ano <br />lnspector is not requhed, <br />Permit Number: <br />Property Owner:{LlC). \,- L c. <br />Contractor:License #: <br />N_,*.in \. {-)'€\l Date:t /r I ry' <br />Have this completed form and the job-card readily available on final inspection! <br />'**Sffi' <br />NAffi <br />P.O. Box 1988 ([I-19) <br />Santa Ana, CA 92702 <br />l7 1 4) 647 -s800 <br />w'a/,r/ santa-ana.ore <br />Signature: