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Planning & Building Agency <br />20 Civic Center Plaza Rcss Annex <br />P.O. Box 1988 {M-19) <br />Santa Ana. CA 92702 <br />(714)M7"5800 <br />w./v'& s lal.l.la I :al <br />Smoke & CO <br />Alarm Affidavit <br />NSP.C2 20 I3 CRC <br />This document may be lound at. <br />Codes and hav <br />ma nufacturer'ctions <br />Siqnature: <br />lcheck on <br />,\,',,,',,, santf -a -a or!,:rcf <br />(Please use a black or blue ink ball-point pen) <br />'26tL,.t.er. Asoen^ P. <br />tOtq-1515 <br />JoR.oe CALVTLLo <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 R314.1 and R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />A eo,h boxes below must be checked: <br />El Carbon 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 gai-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Et 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 contra r or the property owner o f the above project. I further certify <br />that smoke alarms and carbon m ide alarms have been installed in compliance with the governing <br />eb tested to tional. l, also, hereby certify that I will retest the alarms per theL] <br />n sed Contractor <br />NOTE: Ihrs ser-certification is only used lot projects thdt aflect the EXTERIOR of the stucture. This <br />prccess is opplicable ONLY to projects where occess to the interior of the dwelling by d Santa And <br />lnspectot is not requircd. <br />Li Property Owner <br />Project Address: <br />Permit Number: <br />Property Owner <br />Contractor:License #: <br />Dote:'05 .Zotg <br />Have this completed form and the job-card readily available on final inspection! <br />enusAI[A <br />NA,ffi