Laserfiche WebLink
*-SANTA <br />NA/r[Ul <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (Mn9) <br />Santa Ana, CA 92702 <br />(714) 647.5800 <br />wwv/. sa n ta.a na. o rq <br />Smoke & CO <br />Alarm Affidavit <br />Project Address:IWL- O. f$,tvt[wV- uJy <br />Permit Number:ro ( ( (,) L- Kq,1 I <br />Property Owner: <br />Contractor:h.cI+--^ Q*Ln License *, (OZ:a)t) <br />This document moy be lound ot...http :i/www.sanla-ana.orq/pba/ <br />(please use a black or blue ink bail-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 R3L5.3 define <br />the required locations. <br />A ao,]r boxes below must be checked: <br />X Carbon 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 recommended in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />f,smoke atarms: 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. <br />Signoture: <br />lcheck onel Licensed Contractor r Property Owner <br />NoTE: Ihr's sef-certificdtion is only used for projects thot olfect the EXTERIOR ol the strudure. This <br />process is applicoble ONLY to projeds where occess to the interior of the dwelling by o Sonto Ano <br />lnspedor is not required. <br />q.L-{z-Dote t-ti-?-D <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />tr