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*-SANIA <br />NA.ffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (tut.19) <br />Santa Ana, CA92702 <br />(714) 647-5800 <br />,.j///r !1':l-l'r.l <br />Smoke & CO <br />Alarm Affidavit <br />INSP.O2 2C 13 CRC <br />This document moy be lound ot... <br />(Please use a black or blue ink ball-point pen) <br />,,,.,.,,,, s?1:3-an3 <br />Project Address: 7) 11, l/ , tJKl -ra fr*,J.-l^ fr"7" 6/) <br />Permit Number:z6l\ 3)gD <br />Propertyowner: ElQn1;f,r^n <br />Contractor:License #: <br />State of California requlres that smoke and carbon monoxide (CO) alarms are installed in residential <br />bu ild ings. <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 req uired locations. <br />f,\ eoth boxes below must be checked: <br />E Carbon 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 />E 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 governing <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />manufacturer's in stru ctions. <br />Signature: <br />lcheck onel Lice n s Co tractor roperty nerP <br />NOTE: Ihis sef-certificotion is only used for projects thot oflect the EXIERIOR oI the sttudure. This <br />process is opplicoble ONLY to projects where occess to the interior of the dwelling by o Santo Ano <br />lnspectot is not tequired. <br />Have this completed form and the job-card readily available on final inspection! <br />,1 - <br />Dotei I 3Dl />-t t <br />I