Laserfiche WebLink
*,$ANIA <br />.ANAffi <br />Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1938 (l'I-19) <br />Santa Ana. CA 92702 <br />(714) M7.5300 <br />u?'ra,v. s a n ta-a i a. o r:l <br />rNSP-02 2or3 CRa <br />This document mqy be lound ot <br />(check one\ <br />h t1o://,,v.,,r,,r. sa n ia-a na.orq 'pbai <br />(Please use a black or blue ink ball-point pen) <br />Project Address:2017 ], Frr>{tf <br />lanl,qxl <br />Contractor: <br />W tot P"1flrl <br />License # <br />Pe rm it N umber: <br />Property Owner: <br />State of California requires that smoke and carbon monoxjde (CO) alarms are installed in residential <br />bu ildings. <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 requ ired locations. <br />4\ ,o,n boxes below must be checked: <br />d Crrbonmonoxide 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 requlred in bedrooms with gas-fired <br />apylaoces (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 ot 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 ha're been installed in compliance with the governrng <br />Codes and have been tested to be functional. I, also, hereby certjfy that I will retest the alarms per the <br />manufacturer's instructions. <br />tr Licensed Contractor Property Owner <br />N 'tlxJ 4do J" finklerSignoture:Dat e:5 -3o-Zd', <br />Have this completed form and the job-card readily available on final inspection! <br />Smoke & CO <br />Alarm Affidavit <br />NoTE: rh6 self-certification is only used lor projects thot afJect the ErTERI9R of the stucture. This <br />process is applicable ONLY to projects where dccess to the interior of the dwelling by d Sdntq Ana <br />lnspector is not required.