Laserfiche WebLink
*,,SANTA <br />NAqffi <br />! <br />Planning & Building Agency Smoke & CO <br />Alarm Affidavit <br />20 Civic Center Plaza Ross Annex <br />P.O. Bor 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />www, santa-an a. o rq <br />rNSP-02 2013 CRC <br />This document may be found at...http:i/',vlwv. santa-a na.orq/oba/ <br />(Please use a black or blue ink ball-point pen) <br />Project Address:7-z- <br />Permit Number:D\.^,*Vw ;s }L\S r >23' <br />-^ <br />Property Owner:}i OC <br />Contractor:License #: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <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 required locations. <br />fl soth boxes betow must be checked: <br />E Crrbon 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 proiect. I further certify <br />that smoke alarms and carbon monoxide alarms ha been installed in compliance with the governing <br />Codes and have been te ed to be fu nc onal. l,o , hereby certify that I will retest the alarms per the <br />ma n ufacturer's instru on{ <br />(check onel Licensed Contract E- Property Owner <br />NOTE: This self-certificotion is only used for projects thot allect the ErTERIoR ol the strudure. This <br />process is opplicoble ONLY to projects where dccess to the interiot of the dwellinq by a Santa And <br />lnspedor is not rcquired. <br />Signoture:4 Lll ?4)t6 <br />Have this completed form and the job-card readily available on final inspection! <br />Dote: <br />I