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*,SANTIA <br />NA,ffi <br />)'^' "^' r-: _.- !-:::-.:Smoke & CO <br />Alarm Affidavit <br />This document may be lound ot... : : . <br />qPlease use a black or blue ink ball-point pen <br />Project Ad d ress:l ,I Co* n.\ <br />0r o aofl 3l 6 <br />C o ntra ctor: <br />State of California requires that smoke and carbon monoxide {COi alarms are installed in residential <br />b uildings. <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 requ ired locations. <br />Aaoth boxes below must be checked: <br />ECarbon 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, cooktop, furnace) or a fireplace. <br />dsmoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping <br />room, and on each level of the dwellrng. <br />Retrofitted detectors may be battery-operated for buildings where no interior alterations are <br />performed. Combination Smoke/CO alarms must comply urith 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 certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing <br />Codes and have been tested to be functional. L also, hereby certify that I will retest the alarms per the <br />ma n ufacturer's instructions. <br />Signdture: I Dote: \1 t11 <br />(check one)._l.[sosed-coii ractor Property Owner <br />NoTE: Ihis sef-certificdtion is only used fot projects that olfect the EXTERIOR of the stucture. This <br />process is applicable ONLY to ptoieds where dccess to the interior of the dwelling by d Sonta Ana <br />lnspectot is not required. <br />Have this completed form and the job-card readily available on final inspectioni <br />i Property Orvner: iUe . l-rn".,. <br />3b__l <br />0 <br />\t <br />tr tr