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**sAll'[A <br />NA,ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Rsss Annex <br />[']sP,02 2013 CRC <br />This document moy be found at r ..J /\i !r)1/ sa n i:a -a r a.orq,'3 ba <br />(Please use a black or blue ink ball-point pen)76il L <br />State of California requires that smoke and carbon monoxide (CO)alarms are installed in residential <br />b u ildings. <br />California ResidentialCode (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 />J) eo,ir boxes below must be checked: <br />d C^rbonmonoxide alarrns: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarmi are required in bedi-ooms with gas-fired <br />appfnces (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />6S-oL" alarms: Are installed in each room used tor sleeping, in each hallway outside of a sleeprng <br />room, and on each level of the dwelling. <br />Retrofitted detectors may be batte ry-operated for buildings where no interior alterations are <br />performed. Combanation 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. 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 />manufacturer's instructions. <br />{check one\Licensed C ontractor tr Pro perty Owner <br />NOTE: Ihis self-certificdtion is only used for proiects that affect the EXTERIOR of the structurc. This <br />process is opplicoble ONLY to ptojects where occess to the interior of the dwelling by a Sontd Ana <br />lnspector is not required. <br />Have this completed form and the iob-card readily available on final inspection! <br />Project Address: <br />Permit Number:t ts t lza19 <br />Property Owner:nllto horak: <br />C ontractor:ttly-ft.+-Srlar^, License *, \61$6d <br />5 U r2 kls <br />P.O. Box 1988 (M-'19) <br />Santa Ana. CA 92702 <br />(7'14) 647-5800 <br />w &, s I-::l-Ir I al':l <br />Smoke & CO <br />Alarm Affidavit