Laserfiche WebLink
Planning & Building Agency <br />20 Clvic Center Plaza Ross Anner <br />P.O. Bor 1gaa ( l-19) <br />Santa Ana, CA 92702 <br />(71.r) 647.5800 <br />,&,/'/.^/ l lrii-:tri I )r! <br />Smoke & CO <br />Alarm Affidavit*,,SAN[A <br />NA.ffi <br />fhis document moy be found ot. <br />(Please use a black or blue ink ball-point pen) <br />Project Address ,Oq <br />F si''r:a-aiI o'l 3:l <br />c\01/4C <br />^(0-l <br />I clt <br />Property Owner Q NV,u C C /tc <br />Contractor: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildin gs. <br />California Residential Code (CRC) Section R3L4.1and 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 u ired location s. <br />6\ 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 al:o 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 sleeprng <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. lfurther certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governrng <br />Codes and ha're been tested t0 be functional. l, also, hereby certify that I will retest the alarms per the <br />man ufacture r's instrfftions. / <br />rv/License #:A <br />Signdtute: t Dote <br />lcheck onel tr Licen sed Co n tractor P ro perty Owner <br />NOTE: fhis sev-certificdtion is only used lot projects thdt alfect the EXTERIOR of the structure. This <br />process is opplicable ONLY to projects where access to the interior ol the dwelling by o Santo Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Permit Number: ] l <br />'i <br />-1_ <br />i :)