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* NH..NA,M <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1 988 (tu|-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />,,rfr./r/, s a n t3-aa.l, or al <br />Smoke & CO <br />Alarm Affidavit <br />rNSP-C: 2Cr I CRC <br />This document may be lound at... h i1c://,,,,.,r.,,i. san t3 -a na. oa:1c ba., <br />(Please use a black or blue ink ball-point pen) <br />Co ntractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dvrellingsbe <br />"retrofitted with smoke alarms and carbon monoxide alarms, CRC Section R314.3 and R314.3.3 define <br />the req u ired locations. <br />/} eo,l, boxes below must be checked: <br />{C^rAonmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedroonrs and also on each level of the Cwe ling. Alarms are required in bedrcorns with gas-fireci <br />appli ces (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. lfurther certlfy <br />that smoke alarms and carbon monoxide alarms ha're been installed in compliance with the governinq <br />Codes and have been tested to be functional. l, also, hereby certjfy that lwill retest the alarms per the <br />manufacturer's instruction <br />(check one)L .<tcens Con tractor P pe Owner <br />NOTE: fhis sef-c ettification is only used lor projects thdt dffect the ExTERtoR of the structure. This <br />process is opplicable ONLY to projects where occess to the interior ol the dwelling by o Sdnta Ano <br />lnspector is not required. <br />rhis cor availabr <br />>j n <br />d.-0*+ <br />Permit Number:q <br />l.-1 '3aLicense #: <br />l <br />I Project Address: <br />] <br />Property Owner: <br />I <br />Signature:t