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QRF. gEcOORANGE COUNTY FIRE AUTH01 Plan Submittal Criteria Form IF '07110a��{ Required for Single Family or Duplex Residences (Use Commercial form for lots with 3+ dwelling units or new residential tracts) Complete the Project Information and Questionnaire below, then sign and date the Project Information CITY OF SANTA ANA Planning and Building Agency A��ced F03PERMITISSU NCE t Certification. Master ID: Date: ❑ New Single Family Residence/Duplex ❑ Addition/Remodel ADU i El Othei= Address: Unit #: City or Unincorporated County Area: ZIP: M I L S. AAJ A. q'2'70 Scope of Work: Existing Area to Total Resulting Stories: Area Added in Past 2 Years j-I(�.�s e'� - Z- Area : be Added: `73 Area: '� �(3 A � L) - t (excluding this proiect): Yes No Questionnaire OCFA Plan Tvna if " YoW, 1. New- Is this a new single family residence or duplex? *(PR160) Residential Site with Water Availability PR400-401 Fire Sprinkler 2. El W ADU - Is this a new Accessory Dwelling Unit (ADU) on the same property as a house that already has (PR400-402) Fire Sprinkler firesprinklers or a house that will have firesprinklers added as part of thisproject? 3. Ella: Addition - Is this (A) an addition to a currently sprinklered building, or (B) an addition requiring a fire (PR400.402) Fire Sprinkler 5� s rinkler retrofit based on a threshold set by local ordinance? 4. Distance - Is the most remote portion of the addition, ADU or other detached structure greater than *(PR160) Residential Site 140-feet from the fire access roadway? 5. ❑ Total Area - Will the addition result in a total area of greater than 3,600 square feet (sf) for non- '(PR160) Residential Site !� sprinklered buildings, or greater than 6,200 sf for sprinklered buildings, including the area of all with Water Availability enclosed spaces, such as garages, stairs, and detached structures separated by less than 10-feet? 6. C'1 Remodel - Is this a remodel of a sprinklered building with a scope of work that includes adding or (PR40"02) Fire Sprinkler !� removing any interior walls? Note: If "Yes", then project must be evaluated by a C-16 licensed contractor to determine if a firesprinkler modification is needed. 7. ❑ Detached Structure - Is this a new detached utility or accessory structure (not an ADU), such as a *(PR160) Residential Site 4� garage, workshop, game room, pool house, barn, etc., requiring fire sprinklers based on a threshold (PR400-402) Fire Sprinkler set by local ordinance? 8. Gate - Is a gate being installed across a driveway or road that is designated as a fire department (PR180) Gate access roadway, or a driveway or road that serves more than a single home/duplex? 9. ® Methane - Is project located in or less than 100' from a "Division of Oil, Gas, and Geothermal `(PR160) Residential Site Resources" (DOGGR) field boundary or well (active or abandoned), less than 300-feet from an oil/gas '(PR172-174) Methane seep, or less than 1000-feet from a landfill? (Note: For projects in Yorba Linda, this requirement only TestlMitigation Plans applies to new homes, enclosed accessory structures, addition to existing structure greater than 1000 sf, and ADU's). 10. Vegetation - Is the property/structure (A) on the perimeter of a community containing, or adjacent to `(PR125) Fuel Modification slopes or hills, or (B) adjacent to an open space or wildland area containing non -irrigated vegetation, (PR182) Accessory or (C) in a State Responsibility Area or Local Responsibility Area "Fire Hazard Severity Zone", as Structure defined by the State, or D near an area that could be affected by a wildfire in the open space. vvrrN aNNluva reyuli Vu uciuiC lb-judr IL;C ui a yrauncyuuming perms. Hi ouier plans types may De aererrea suomivais. Applicant Certification Icertif under penalty of perjury, under the laws of the State of California, that the information above is true: . r PrintNamb: n X-5 L Signature: — Date: /e 25 - Phone Number: Email:_OE'r,2r✓ I 72�1 5:ccyNST>-uc nc.,� c,) ^4 sr'v . C 0 Attention Building Department Staff - After you've verified all questions were answered accurately as "No", then you may accept this signed form as a written release that an OCFA review is not required. If any questions were answered as "Yes", then the plan type on the right side may be required. If all answers are "No" and the Building Department still requires the applicant to have their plans reviewed by OCFA, or if any answers are "Yes" and the Building Department prefers for OCFA to determine if a review is required, please initial this line and provide an explanation on the Plan Referral Form (on the reverse), to be submitted along with the appropriate plans to OCFA for a determination. For questions and submittal information, please visit ocfa.org, or call 0CFA at (714) 573-6100