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ftsP-t2 2113 CPa <br />This document moy be lound at...h ttp.i /Y{w!!. sa n ta-a na. olq/Boai <br />(Please use a black or blue ink ball-point pen) <br />*-SNTA <br />NAffi <br />Planning & Building Agency <br />20 Civic Cehter Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana. CA 92702 <br />(714) 647.s800 <br />www.santa-an a. orq <br />Smoke & CO <br />Alarm Affidavit <br />Project Address <br />Permit Number: <br />3i7+ <br />9sti <br />t <br />I qt 6+ <br />Property Owner.q <br />lContractor:tffir"^^X,e^ ( D-rt i License #It,cStd-XlT <br />State of California requires that smoke and carbon 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 />Aao,n boxes below must be checked: <br />$karbon monoxide alarms: Are installed outside of each steeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />$Smok9 alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />r6om, 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. l, also, hereby certify that lwill retest the alarms per the <br />ma n ufacture r's instruct ions. <br />Lic sed Contractor trP rope Owner <br />Signdtute: <br />+(check onel n <br />NOTE: Ihis sef-c ertificotion is only used lor projects thdt dffed the EXTERIOR ol the structure. This <br />process is opplicoble ONLY to projects where access to the interiot ol the dwelling by a Santd Ano <br />lnspectot is not required, <br />Have this completed form and the job-card readily available on final inspectionl <br />\l Y/r,)rgL [u.^t ll^* <br />Date: <br />I <br />____)