Laserfiche WebLink
ffi'HSANI* <br />#NAffi <br />Planning & Building Agtncy <br />20 Civic Cent-.r Pla:a Rcss Ann-.x <br />P.O. Box 1938 (i!l-19) <br />Santa Ana, CA 92702 <br />(711) 547.5a00 <br />a.ora <br />Smoke & CO <br />Alarm Affidavit <br />lfisP,o2 20 r3 cRc <br />This document moy be found ot-..htiO://,,,r'','rr,,l.Santa-ana.Or o/oba/ <br />(P/ease use a black or blue ink ball-point pen) <br />(check onel <br />?o'/ <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <br />California ResidentialCode (CRC) Section R314.1and R315.2 states in part that existing dwellings be <br />"retrofitted rvith smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define <br />the required locations. <br />/^\ <br /># U aoth boxes below must be check:d: <br />tl Crrbrnmonoxide 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 required in bedrooms uiith gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />WSmoke alarms: Are installed in each roon used for sleeping, in each hallway outside of a sleeprng <br />room, and on each level of ihe d,r,relling. <br />Retrofitted detectors may be battery-operated for buildings urhere no interior alterations are <br />performed. Combination Smoke/CO alai.ms must comply with all applicable standards and be approved <br />by the St3te 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. t, also, hereby certify that I will retest the alarms per the <br />ma nufactu rer's instructions. <br />Z'1' 2 zl <br />Licen sed Contractor Property Owner <br />NOTE; Ihis sef'c ertification is only used for projects that dflect the ExTERtoR of the structure. This <br />process is opplicdble ?NLY to projects where access to the interior ol the dwe ing by a 50nta Ano <br />lnspector is not required. <br />)< <br />Proje ct Ad d ress:L ( <br />Permit Number:L <br />Property Owner:z 2- <br />Contractor:License #:() <br />Signoture:zt.)aitn.l r,rt C brel.^ zl4l Datz: <br />Have this completed form and the job-card readily available on final inspection! <br />I <br />I <br />I I