Laserfiche WebLink
*,,$ANIA <br />A]{A,ffi <br />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 />Yf,r/./r/, s a n ta -a r't 3. or?, <br />7 rNSP-02 2!1t CRa <br />This document mqy be found ot...h tlp:/r',,,.,,i,,,i sa nta -a ne. oro,loba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Project Ad dress:4o5 h,. F{o?}:,r <br />?pbAnLr <br />Qb,rncs.. lq. tZ>r,,nQt;7; <br />Contractor:License #: <br />Permit N umber: <br />Property Owner: <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u il.dings. <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 aiarms. CRC Sect,on R314.3 and R314.3.3 define <br />the requ ired loca tions. <br />f\ aotlr boxes betow must be checked: <br />ECarbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of <br />bedroorns 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 />ELSmot e 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. 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 e functional. l, also, hereby certify that I will retest the alarms per the <br />ma n ufactu rer's stru ctio <br />Licensed Contractor ope Owner <br />NQfE: This self-certificdtion is only used lor projects thot aflect the EXTERIOR ol the structure. This <br />process is applicable ONLY to projects where occess to the interior ol the dwelling by a Santa Ana <br />lnspector is not tequired. <br />Have this completed form and the job-card readily available on final inspection! <br />Signoture:ootr' lr6f IO <br />Smoke & CO <br />Alarm Affidavit <br />I <br />(check one)E