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20 Crvrc Cgnter Plaza Ross Anner <br />Planning & Building Agency <br />INSP.O22CI]CRC <br />This document mqy be found at,,,hi:,1 ,,r,,,',,, s3nir-ll-1 o 3Cl <br />fPlease use a black or blue ink ball-point pen) <br />II Project Address:1\3 (1,Av <br />o Iq1 L <br />I Property owner Cheri /''1\o qn <br />Contractor:(11 e (o'A License #1B'/ bLL <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <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 R31"4 3 and R314.3.3 define <br />the required locations. <br />A eorh boxes below must be checked: <br />E Carbon monoxide alarms: Are instalted outside of eech sleeping area in tne rmmedrate vicrnity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with g?s-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />El 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 rnay be batter,y''operated for buildings where no interior alterations are <br />performed. Combinatjon Smoke/CO alarms must comply with all applicable standards and be approved <br />by the State Fire Marshall (SFlvl). 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 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 ufactu re r's instructions <br />Signoture Ddte:g.z?.lg <br />lcheck onel A CE sed Contractor Property Owner <br />Have this completed form and the job-card readily available on final inspection! <br />*-SAI\rlA <br />NA,ffi <br />P.O. Box 1988 ([r-19) <br />Santa Ana. CA 92702 <br />(714) 647.s300 <br />,r'^/.r ; t.!a-a. t r/l <br />Smoke & CO <br />Alarm Affidavit <br />Permit Number: <br />tr <br />NOTE: fhis sef-c ertificdtion is only used for projects that dffect the EXTERIOR of the stucture. This <br />process is applicoble ONLY to projects where occess to the interiot of the dwelling by a Santa Ana <br />lnspector is not required.