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'ffiffi <br />Plannlng & Building Agency <br />2, Crvrc Centa' Plus Rsss Anrr ( <br />P.O Bor ,$a (ll-l9l <br />Srnt! An.. CA 92702 <br />(7,lr) 647.5600 <br />? tr,'! i 1" t.1- r _ ' <br />Smoke & CC <br />Alarm Affidavit <br />fhis dccument moy be fuund at,.. <br />(Please use a black or blue lnk ball-Nint rr-n) <br />ject Address: <br />Permit NumbEr: <br />I Property Owner:c-+f,A da'rso) <br />lContractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are initalled in re5ide4t:a! <br />buildings. <br />California Residential Code (CRC) Sectron R3ll.1and R315.2 staEs in part that existin8 dwellings be <br />"retrofitted with smoke alarm; and carbon monoxide alarms. CRC Section R311.3 and R314.3.3 define <br />the required locations. <br />fl ** boxes below must be checkld: <br />E C"rOon monoxlde alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on eich level olthe dwelling. Alarms are required in bedrooms with gas-fired <br />appliances (i.e. hot wster he3ter, cooktop, fumace) or a fireplace. <br />E S-ot. alarms: Are installed in each roorn used for sleeping, ln 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 lvlarshall (SFtvl). Battery life must be 10 years. <br />I hereby certif.T 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 thegoveming <br />Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the <br />manufacture/s instructions. <br />, Slgnature: E/O*a Dot?: ol Jaa,l <br />lcheck onel tr Licensed Contnctor tr Property Owner <br />NOTE: Ihrs sef-c ertification is only used for projetts thdt ofled the ErTERIOR of the structure. This <br />process is applicoble ONLY tc projects where access to the interlot ol the dwelling by a Santo Ano <br />h7jpector is not requited. <br />Have this completad form and the job-card readily available on final lnspectionl <br />I