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Plannin g & Building Agency <br />20 Civic Center Plazg Rosi An.ex <br />P.O. Box 1 3Aa (iu-19) <br />Santa Ana, CA 92702 <br />(711) 647.s300 <br />,"iYiv.sIi:3-aat. )rf <br />Smoke & CO <br />Alarm Affidavit <br />Project Address: <br />Prope rty Owner: <br />lfrsP'02 2Cll aRC <br />This document may be f ound at... h ii::/ ,ri,';,r sa i:3 -a:t:. c.l,'c b 3.' <br />Permit N umber: <br />Contractor:s License #: <br />State of California requires that smoke and carbon monoxide lCO) alarms are installed in residential <br />buildings. <br />California Resid:ntial Code (CRC) Section R314.1and R315.2 st3tes in part that existing dr,,relling: be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the requ ired loca tions. <br />f\ aotr, boxes betow must be checked: <br />V Carboo monoxide alarms: Are installed outside of each sleeping area in the irnmediate vicinity of <br />bedroonrs and also on each level of the dwelling. Alar,'ns are required in bedrcorns with gas-fireci <br />appli4nces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />[!fsmoke atarms: Are installed ir each room used for sleeping, in each hallway outside of a sleepirg <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be ba tte 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 ha,re been installed in compliance with the governrng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />ma n ufa cturer's instructions. <br />Signotute:Dat 2: <br />(check one)Llcense Contr'3ctor B.. P ro perty Owner <br />NOTE: fhls sef-c ertifi cotio n is only used far prcjects that offect the EXTERIOR of the structure. This <br />process is applicable ONLY to projec$ wherz access to the inteiot ol the dwelling by a Sonta Ano <br />lnspector is not rcquired. <br />Have this completed form and the job-card readily a,railable on final inspectionl <br />l0Z F So in- <br />(Please use a black or blue ink ball.point pen)