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rNsP{2 2013 CRC <br />Thls documcnt may be tound ot..,http ://www. sa nt a - an a.or ol pba I <br />(Please use a black or blue lnk ball-polnt pen) <br />Proiect Address:It f \^/ ?"r fi LL, <br />2o 17Zo T <br />Property Owner:LOrl,Se 1/otitf <br />Contractor:License #: <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 />Aso,t bores below must be checked: <br />E C"rbon 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 gas-fired <br />appliances (i.e. hot water heater, cookop, furnace) or a fireplace. <br />Etr 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. I further certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the toverning <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacture/s instructions. <br />Slgnotwe L 0+u4> 5/An4/{l/tT/zt <br />lcheck onel Ef Licensed Contractor Property Owner <br />NoTE: This serr-ceftificotion ls only used lor projcds thot ollcct the offERtoR oI the sl/:ucturc. Thls <br />process is opplimble ONLY to prciects where occess to the interior ol the dwelllng by o Sp,nto Ano <br />tnspectot ls not rcqulrcd. <br />Have this completed form and the job+ard readily available on final inspectionl <br />Planning & Bullding Agency <br />20 Clvlc C.nter Plua Rosr Annex <br />P.O. Box l98E ( -10) <br />Srnt! An!, CA92'r02 <br />(714) 647-s800 <br />www.atnta-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />, <br />Permit Number: <br />Dote: <br />tr