Laserfiche WebLink
Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (M-'19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />www.santa-ana.otq <br />Smoke & CO <br />Alarm Affidavit <br />rNSP{2 2013 CRC <br />This document mdy be lound dt...http://wwr,v. santa-ana.or ql pba/ <br />(Please use a black or blue ink ba -point pen) <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 />A*,n boxes below must be checked:J <br />lAl&rbon 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 requrred in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Efffiofe 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 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 tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instructions <br />lcheck onel tr sed Contractor Property Owner <br />NOTE: This self-certificotion is only used for projeds thot olfed the EXTERTOR ol the strudure. r]his <br />process is opplicoble ONLY to prcieds where dccess to the interior oI the dwelling by o Sontd Ana <br />Inspector is not required. <br />b <br />Proiect Address:4la t'H /' ..fr,ll/r zznl <br />Permit Number:./n./ oAl//, <br />Propefi Owner:2 <' /rr,-.1 r-z-,v,mzl^-t <br />Contractor: CtZ Z,o. 6r- ]Li""n"" #, A-z^?L/,anr', <br />Siqnoture:I Date:-)/ <br />Have this completed form and the job-card readily available on final inspection! <br />-,-SANTA <br />NAJ{d* <br />I