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,,-SANTA <br />NAJII}ffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-19) <br />Sanla Ana, CA 92702 <br />(714) 647-s800 <br />www.sanla-ana.orq <br />This document mdy be found ot...http :i/ww\ /. sallta-ana.OIqlBba/ <br />(please use a black or blue ink.W-point pen) <br />Permit Number:ot <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 R315.3 define <br />the requ ired locations. <br />Asott boxes below must be checked: <br />,EfCarbon 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 recommended in bedrooms with gas-fired <br />appliances (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. <br />Signdture:C-Y-t--Ot <br />lcheck onel Licensed Contractor Property Owner <br />NOTE: This seff-certilicotion is only used for projects thot olfect the EXrEHOR ol the strudure. This <br />process is applicoble ONLY to proiects where occess to the interior ol the dwelling by o Sonto And <br />lnspector is not required, <br />Dote:,l <br />Have this completed form and the job-card readily available on final inspection! <br />Project Address: 71U. 9- flr,v Dr. <br />Property Owner: I ?a,tl Hzcl<f,gr- <br />tr