Laserfiche WebLink
$ANIA <br />NA,ffi <br />m0t <br />Planning & Building ASency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box l988 (M.19) <br />Santa Ana, CA 92702 <br />(714) 647-s800 <br />w1^./v. s i nta-a n r. orq <br />Smoke & CO <br />Alarm Affidavit <br />x <br />lNSP42 2013 CRC <br />This document moy be lound ot...h tt o :/A,,lan v . sa n ta-ana.orq/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />Property Owner: <br />Co ntractor: <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 />4\ ao,h boxes betow must be checked: <br />E Carbon monoxide atarms: 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 atl applicable standards and be approved <br />by the State Fire Marshall (SFM). Battery life must be i0 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 />(check onel tr Licensed ontractor roperty Owner <br />NoTE: Iirt sef-certificdtion is only used lor projects thot qllect the ExTERloR of the structure. This <br />process is opplicoble ONLY to projeds where occess to the inte or ol the dwelling by o Santo Ano <br />lnspectot is not requircd., <br />Have this completed form and the job-card readily available on final inspection!v <br />Project Address:) <br />Permit Number:otq <br />tic,io <br />License #: <br />I tl c>_ot <br />I <br />Sign ure Doty f -2?-2o/) <br />I <br />/1 <br />I