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/ <br />P.O. Box 1988 ([4-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />y/,r'/.I/. s aa t3-aa I or <br />Smol<e & CO <br />Alarm Affidavit <br />Project Address:qS <br />c,h)I L Jc <br />Contractor:Li <br />nlsP 02 2!13 CRa <br />This document may be Jound at... httc //,,,r,r',v Santa-3ne of q/oca' <br />(Please use a black or blue ink balt-point pen) <br />Permit Number: <br />Prope rty Owner:L y' tl'\f,/ < <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <br />California Residential Code (CRC) Section R3L4.L and 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 />f\ eo,rr boxes below must be checked: <br />dcarbon monoxide 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 />app nces (i.e. hot water heater, cooktop, furnace) or a fireplace <br />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 />manufacturer's in str lons <br />lcheck o Pr pert ner <br />NoTE: rhls self'certificdtion is only used for projects that aJIect the EXTERI1R of the structure. This <br />process is applicable ONLY to projects where occess to the interior of the dwelling by d Sontd Ana <br />lnspector is not required. <br />Signdture:--fr Dote:9ts//. <br />'IGItrTT <br />o lanning & Builc!tng t,5 <br />20 Civic Center Plaza Ross Annex <br />3 <br />cense <br />Lice n sed Contractor-,