Laserfiche WebLink
**SNIA <br />NAffi <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M.19) <br />Santa Ana. CA 92702 <br />(7r4) 647.s800 <br />www.santS-ana-orq <br />lrSP-,12 2t'I lR: <br />fhis document moy be found ot...h ttC;/i,rrr,v,,v sa nte -a na. orq/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Address:/*a t?z.to z <br />Permit N umber:EAS- <br />Contractor:€License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ing s. <br />California Residential Code (CRC) Section R3l.4.1and 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\ so,r, boxes below must be checked: <br />,rFearbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />1/bedrooms and also on each levei of the dwelling. AIarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace, <br />I <br />1!S.of " <br />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 Fir-. Marshall (SFM). Batten/ life rnust 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 t?sted to be fr.rnctional. I also, hereby certify that I will retest the alarms per the <br />ma n u facturer's instructions <br />Signatute: <br />lcheck one Licen sed Con t13ctor P ope Owner <br />NOTE: fhis sef-c ertification is only used lor projects thdt aflect the EXTERIOR ol the structure. lhis <br />process is applicable ONLY to projects where occess to the interior ol the dwellinq by d Sontd Ana <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspectionl <br />PropertyOwner: Zr/n;/,/.., <br />tr <br />Dote: