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*-SANTA <br />NA <br />llt\\l\c <br />iltI.DIIC <br />lfi\0 <br />Planning & Building Agency <br />2C Civic Cent3r Plaza Rcss At:19x <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />,vu.//.santa-an a.o rc <br />Smoke & CO <br />Alarm Affidavit <br />This document moy be lound ot... <br />(P/ease use a black or blue ink ball-poi <br />Project Address: <br />Permit Number: <br />Contractor: <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 />Asoah boxes below must be checked: <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />appli es (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 />oom, 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). Ba must be 10 years. <br />I hereby certify that I am th ntracto r the property owner of the above project. I further certify <br />that smoke alarms and carbon mo de alarms have been installed in compliance with the governing <br />Codes and have been tested functional. l, also, hereby certify that lwill retest the alarms per the <br />manufacturer's instruct <br />(check onel Licensed Contractor Pro rty Owner <br />NOTE: Ihis sef-certificotion is only used for projects thot oflect the EXTER|,OR ol the structure. This <br />process is dpplicoble ONLY to projeds where occess to the interiot of the dwelling by d Sdntd Ana <br />lnspector is not required. <br />>o,bGa <br />L <br />\a</a License *, 8t {/ot/ <br />Signoture: I Q-/ <br />Have this completed form and the job-card readily available on final inspection! <br />r\sP-c2 2c'3 il:.j <br />Property Owner: <br />Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />tr <br />LI^f( <br />Dote: