Laserfiche WebLink
Pla.nning & Building Agency <br />20 Civic Center Plaza Ross Annex <br />P.O. Box 1988 (to|-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />r: r'r-r 5 lrl'l.lr rl.!rq <br />Srnoke & CO <br />AIarm Affidavit <br />This docufient may be iound at.f .:f . ,'.',','.,.;? i'.'-r^'r t.; t .: <br />(please use a black or blue ink ball-point pen) <br />7- \t L (,,-\.,o.,o a+ <br />Permit Number:/0t/2:\oz/-J <br />Property Oviner:/z,r,au v(2L{ <br />Contractor:cb(^ f^,],,.,-\'r-License #:/e3as7L <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existlng dwellings be <br />"retrofitted with smoke alarms and carbon rnonoxide alarms. CRC Section R314.3 and R3L5.3 deflne <br />the requ ired locations.n\(.l ll Both boxes beloyr must be checked: <br />E 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 />E Smoke alarms: 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 Fi;'e Marshall (SFM). Batteri life must be 10 yeai's. <br />I hereby certify that I am the contractor or the property owner of the above project. I furlher 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 />(check one)tr Licensed Con ctor tr Property Owner <br />NATE: This self-certificatian b only used for projeds thdt ofled the EXTERIOR ol the strudurc. This <br />process is opplicable ONLY to projects where access to the interior of the dwelting by a Sontd And <br />lnspector is not required. <br />Have this completed form and the job-card readily available on final inspection! <br />Signdture://,.*/Ddte: <br />Project Address: i <br />I