Laserfiche WebLink
*,$AN[A <br />NA.ffi <br />Planning & Building Agency <br />20 Cr./ic Cenrer PlazJ Ross Annei Smoke & CO <br />Alarm AffidavitP.O Bor 1383 (iU-13) <br />Santa Ana, CA 92702 <br />(711) 647-5300 <br />wt^.& s rrl.1- r- I t.-l <br />fhis document moy be lound o:h ,.,'r, / ;t':-t-I1l ^,(-::l <br />(Please use a black or blue ink ball-point pen, <br />Project Address:70 L <br />Permit Number: <br />Prope rty Owner ( <br />Contractor:License #: \fi <br />St3te of California requires that smoke and carbcn nnonoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC)Section R314.1rnd R315.2 states in part that existing dwellings be <br />"retrofitted with smoke alarrns and carbon monoxide alarms. CRC Section R31+.3 and R314.3.3 define <br />the requlred locations. <br />A aotn boxes below must be checked: <br />p CarUon monoxide alarms: Ar'e installed outside of each sleeping area in the immediate vicinity of <br />bedrooms and also on each level of the dwelling Aiarms are required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnare) or a fireplace. <br />nsmoke alarms: Are installed in e3ch room used for sleeping, in each hallway outjide of a sleeping <br />lodm, and on each level of the dwelling. <br />Retrofitted detectors may be battery-operated f0r buildings where no interior alter3tions are <br />performed. Combination Srnoke,/CO alarms mustcomply with all appllcable st3ndards and be approved <br />by the State Fire lvlarshall (SF[,!). Battery life musr be 10 years. <br />I hereby certrfy that I am the contractor or the property owner of the above proJect. I further certify <br />that smoke alarms and carbon monoxide alarms rave been instelled in compliance with the governrng <br />Codes and have been tested to be functjonal. l, arso, hereby certify that I will retest the alarms per the <br />manufacturer';ct ons <br />5iq noture:Oat Z Z;z-o <br />lcheck one rcensed Contract or Property Owner <br />NOTE: fhrs self-certificdtion is only used lor proj?ct thot affect the ErTERIOR of the structure. This <br />process is dpplicdble ONLY to projects where access to the interior of the dwelling by a Santa Ano <br />lnspector is not required. <br />Have this completed form and the job-crrd readily available on final inspection!