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Property Addre�s:
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�rief Job:De�cription: : �� ►zo o r.: � _
Number of smoke alarrr�s installed: �
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Number.of carbon monouide alarms installed: Z : : .
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VVhen alterations, repairs or additions requiring a:permit occur; or�leeping`rooms are created, ,
Smoke alarms.stiall be insfalled in each sleeping. room, and outside each separate -.
sleeping ar.ea in_the immetliafe vicinity of the bedrooms; and on each additional_ story:of the . . .
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� dwelling, including basernents and habitable attics as required.by Sectiqn R314 of the.2Q16.
CalBfo�nia Residential Code.(C.RC) and California He.alth and:Safety Code Sectioh 13113.7.:
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F.or dwelling� or.s.leeping units.contairiing fuel :burneng appliances or having attached
garages,.ca�bon morioxide alarrras shall be insfalled outside each .separate sleeping
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area: in the immediate vicinity of the .betlrooPns, antl�.on each addifiorial sto�i of the
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dwelli.ng, .including..basements as. .required by Section R31�5 of fihe of the-.2016 California .
Residentia6 Code..(CRC): .
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Multi-purpo�e alarms.(cornbination.carbon monoxide:and.smoke ala�ms) may be used, .
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All alarr�r�s"shall:connply vvith requi�einents:for listing and:approval 6y:the.O.ffice of:the State Fire
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As ovvner.of tfie above.i-eferenced prope�ty, l hereby certify that the srv�oke alarms and carbon
rnonoxitle alarms h.ave been install.ed in accordance with_the rnanufacturer's instruction�.and in
compliance with the code sections.referenced above. ,
I d���a�e �e�c�er ��raaltgo.�f��rJur.�.t���the foP�g�i�� a� true ��d co�rect; a�d t@��t.th�� ..�
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de���r�tq�n r�as ���c�ted o Da�e lo � � �2��2 . : � at�r�adia9 C�I�f���ia. . .
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�egna4�re o��w���: � _ _ . . :
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�Tha� affidavit must be returned.to fihe. cadia inspector prior to:.final in�pection
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