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Pl.anning & Buildiag Agency <br />20 Civic Cscter Plala Ross Adn6x <br />P.O, Box 1988 {u-'19) <br />S.nta Ana, CA 92702 <br />(7r4) 547.5E00 <br />Smoke & CO <br />Alarm Affidavit <br />fhis document mqy bc lound ot... <br />(please use a black ot blue ifik ba -point pen) <br />Projact Aodrass:L\ti N. l,turtuu) <br />Pgrmit Numb€r:(B) lol rr:rt19 <br />\,p-A <br />Contractcr:_!fJl^r1-Licanse #: n1l1 <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Rasidential 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 section R314.3 and R315.3 define <br />the requ ired locations. <br />A aotir uo".s belox must be checlred: <br />Q C"Aon r.ronoxide 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, furnacelor a fireplace. <br />S 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 detecto15 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). Banery life must be 10 years. <br />I hereby certify that I am the contractor or the property owner of the above project. I fu(her 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 />Itheck one)Licensed Contractor tr Prop rty Owner <br />NorE: rhis serl-c ertifrcttion is only used Io. prolects thot aflecr the ExrERtoR of th,e slauc-turr. This <br />grccess is applicoble ONLY to proj?cts rch€le q€cess ro the lnteior of tha dwe iag by a Sonta Aaa <br />lnspector is not Gquircd. <br />H.aye this completed forrn and the job-card readily available on final inspert:onl <br />Signature:z Ddte:7l ,1 <br />,t[J*,ili <br />Propei'ty Owner: