Laserfiche WebLink
!NS2-02 2,1: 3 aRa <br />fhis document mdy be lound ot htiD ,M,v,r'r' sa n ta-a na.orqi obai <br />(Please use a black ot blue ink ball-point pen) <br />Project Address:iolo S$E <br />PermitNumbe,' l* DI q3A, QrX <br />Nooo L^) qen 6 <br />*,SA}I'TA <br />NAffi <br />Planning & Building Agency <br />20 Civic Center PIaze Ross Anner <br />P.O. Box 1988 (M.'19) <br />Santa Ana. CA 92702 <br />(714) 647.s800 <br />www santJ-ana.orq <br />Smoke & CO <br />Alarm Affidavit <br />Property Owner: 11g.6urE Lt17aFrn Ayent La,-t7o) <br />Contractor:6t NN (*Lice nse #:%1" a+q <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 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 req u ired loca tions. <br />f,\ eo,h boxes below must be checked: <br />XCrrOonmonoxide alarms: Are installed outsrde 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 g:s-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />Ys^oU."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 appro'red <br />by the State Fire Marshall (SFM). Battery life rnust be 10 yeai.s. <br />I hereby certlfy 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 governrng <br />Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacturer's instru <br />tr Licensed Contractor <br />Dote +/t' <br />N Property Ownerlcheck onel <br />NOTE: Ihrs sef-c ertilicdtion is only used for projects thdt dffect the EXTERIOR ol the structure. This <br />process is applicoble ONLY to projects where access to the intetiot ol the dwelling by o Sonta Ano <br />lnspector is not requircd. <br />Have this completed form and the job-card readily available on final inspection! <br />Sig natu re: