Laserfiche WebLink
*-SANIA <br />,.A}IAM <br />Planning & Building Agency <br />20 Civic Center Pla:3 Rosi Annex <br />P.O. Box 1983 itu|.19) <br />SanE Ana, CA 92702 <br />(71.t) 6.17-5a00 <br />Smoke & CO <br />Alarm Affidavit <br />il-l^t )i; <br />N aD A. rAr l aO^ <br />This document may be found ot... i1':3 ,' ,,r,,r,',,, sali:-al:.C 0,:b: <br />(Please use a black or hlue ink ball-point pen) <br />Project AC dress:Z.5o< S Ro.r^-,...- Dc <br />Permit Number 13( l zor ztll <br />Pro perty owner: <br />State of CaJifornia requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />b u ild ings. <br />California ResidentialCode (CRC) section R314.1and R315.2 states in part that existing dwellings be <br />"rerrofitted ',,/ith smoke alarms and carbon monoxide alarms. cRC secuon R314.3 and R314.3.3 define <br />the required loca tions. <br />f\eotl tor"s betcw must be checkec: <br />#.rraon monoxide alarms; Are installed outside of each sleeping area in the irnrnediate vicinity of <br />bedrooms and also on each level of the dwelling. Alarms are required in bedrooms u/ith gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace._/) <br />*d'Smoke alarms: Are ins:alled in each room useC for steeping, in each hall,r,,ay outside of a sleeping <br />room, anC on each levglgf 1r'g 6v,/a i:at <br />Retrofitted detectors may be battery-operaieC for buildings where no interior alteraiions are <br />performed. Combination Smoke/CO alarins must comply with all aeplicable standards and be approved <br />by fhe State Fire ltrlarshall (5FM). Battery life must be 10 years. <br />I hereby cerlify lhat I am the contractor or the property o,riner 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 test-.C to be functional. 1, aiso, hereby certlfy txat I wili retest the alarms per the <br />ma n ufacturer'5 instiuct <br />Signature <br />lcheck oneJ Y d Contia.tor <br />Dot e:to/ 3 t/t) <br />tr Property ownercen 5e <br />N orE: rhrr sef-certificdtion is only used lor projects thdt offect the ExrERtoR ol the stucture. This <br />process is applicable ONLY to ptojects where occess to the interior ol the dwelling by o Santd And <br />lnspector is not required. <br />TeSe Ofozc-o <br />S.,.,.6s,^^.L g..,,'Contractor:efJ <br />Have this completed form and the job-card readily available on final inspectionl <br />Lice nse #: I d.o) o I L/