Laserfiche WebLink
Planning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (lvl-19 ) <br />Santa Ana. cA 92702 <br />{714) 647-5A00 <br />Smoke & CO <br />Alarm Affidavit <br />1a.x <br />INSP-022!llCRC <br />This document may be found ot hlic:' <br />"vii",; <br />s3nla-ara or t,3ba <br />(Please use a black or blue ink ball-point pen) <br />Project Add ress:,Atb / fr /// /7 /ntna <br />Permit N umber:/0 /QP44Z r <br />Property Owner: <br />Contractor: <br />I <br />Lice nse #: <br />/uon l./art <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California Residential Code (CRC) Section R314.1and R3l-5.2 states in part that existjng 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 />A eoth boxes below must be checkec: <br />p Carton monoxide alarms: Are installed outside of each sleeping area in the immedrate vrcinity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired <br />,applr-ances <br />(i.e hot water heater, cooktop, furnace) or a fireplace. <br />N Smoke alarms: Are installed in each room used for sleeping, in eacl^ hallway outside of a sleeprng <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. l, also, hereby certify that I will retest the alarms per the <br />man ufactu rer's instructions. <br />(check one)tr Licen sed Contractor P ro perty Owner <br />NOTE: fhrs sef-c ertificotion is only used lor projects thot affect the EXTERTOR of the structure. This <br />process is applicdble ONLY to projects where dccess to the interior of the dwelling by a Sonta Ano <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspectionl <br />Signdture:LOM Dote /- z/ -/q <br />*,SANIA <br />NAffi