Laserfiche WebLink
I <br />Planning & Bullding Agency <br />20 Civlc C.nbr Plaza Ross Ann.x <br />P.O. Box tgEA (Ml9) <br />gantr Anr, CA 92702 <br />(7r4) 047.5800 <br />www.sanla.ana-6rn <br />Smoke & CO <br />Alarm Affidavit <br />ProJect Address: <br />Permit Number: <br />g\7 uJ s!.urrs Nrc <br />tOt\oqo.2-s <br />Property Owner:AJvr ^r,, Mo^o*^.,.orJ <br />Contractor: <br />.rJ <br />n-""tr;u,L^License#: Zj"\r+ C.+ <br />rNsP{2 2013 CRC <br />lhis documcnt mdy be lound ot.,,http:/iu^.nv.santa-ana.orq/pba/ <br />(Please use a black ot blue ink bail-polnt pen) <br />State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential <br />buildings. <br />California Residential Code (CRC) Section R314.1and R315.2 states in part that existing 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 />6\ soti, boxes below must be checked: <br />4 <br />EI 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 required in bedrooms with gas-fired <br />appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. <br />A Smofe 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 rnust 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. lfurther certify <br />that smoke alarms and carbon monoxide alarms have been installed in compliance with the governinS <br />Codes and hav€ been tested to be functional. l, also, hereby certify that I will retest the alarms per the <br />manufacture/s instructions. <br />lcheck onel tr License ntractor P ro perty ner <br />NOIET rhis self-ccrtiftcation is only used lot projcc,;s thot orlect the EXTERIOR ol thc sttucture. This <br />process ls applicoble ONLY to proiects wherc occcss to thc intcriot ol the dwelling by o Sonta Ano <br />lnspector is not requlred, <br />Slgnature:frrlr,o^n- Nl,*,,,r**dl Dote 03/L <br />Have this completed form and the job-card readlly avallable on final inspoction! <br />-,-SANTA <br />NAJIilili