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fIRF <br />ORANGE COUNTY FIRE AUTHORIT <br />Plan Submittal Criteria Form <br />Required for Single Family or Duplex Residences <br />(Use Commercial form for lots with 3+ dwelling units or new residential tracts) <br />Complete the Project Information and Questionnaire below, then sign and date the <br />Project Information <br />❑ New Single Family Residence/Duplex ❑ Addition/Remodel —ADU <br />CITY OF SANTA ANA <br />Planning and Building Agency <br />AcRed <br />FOR ISSUANCE <br />it Certification. <br />Master ID: <br />Date: <br />Address: Unit #: City or Unincorporated ounty Area: ZIP: <br />St � � l�cs Z � a Ta <br />Scope of Work: <br />0?_ JP5`�J <br />Existing Area to e►,' Total Resulting Stories: Area Added in Past 2 Years <br />Area: be Added: L Area:(excluding this pro ect : <br />Yes No Questionnaire OCFA Plan Type if "Yes" <br />1, <br />New- Is this a new single family residence or duplex? <br />*(PR160) Residential Site <br />with Water Availability <br />PR400-402 Fire Sprinkler <br />2. <br />❑ <br />171 <br />ADU - Is this a new Accessory Dwelling Unit (ADU) on the same property as a house that already has <br />(PR400-402) Fire Sprinkler <br />J� <br />firesprinkle s or a house that will have firesprinklers added as part of thisproject? <br />3. <br />Addition - Is this (A) an addition to a currently sprinklered building, or (B) an addition requiring a fire <br />(PR400-402) Fire Sprinkler <br />sprinkler retrofit based on a threshold set by local ordinance? <br />4. <br />El <br />71 <br />Distance - Is the most remote portion of the addition, ADU or other detached structure greater than <br />*(PR160) Residential Site <br />140-feet from the fire access roadway? <br />5. <br />❑ <br />Total Area - Will the addition result in a total area of greater than 3,600 square feet (sf) for non- <br />*(PR160) Residential Site <br />sprinklered buildings, or greater than 6,200 sf for sprinklered buildings, including the area of all <br />with Water Availability <br />enclosed spaces, such as garages, stairs, and detached structures separated by less than 10-feet? <br />6. <br />Remodel - Is this a remodel of a sprinklered building with a scope of work that includes adding or <br />(PR400-402) Fire Sprinkler <br />removing any interior walls? Note: If "Yes", then project must be evaluated by a C-16 licensed <br />contractor to determine if a firesprinkler modification is needed. <br />7. <br />Detached Structure - Is this a new detached utility or accessory structure (not an ADU), such as a <br />*(PR160) Residential Site <br />garage, workshop, game room, pool house, barn, etc., requiring fire sprinklers based on a threshold <br />(PR400-402) Fire Sprinkler <br />set by local ordinance? <br />8. <br />E] <br />Gate - Is a gate being installed across a driveway or road that is designated as a fire department <br />(PR180) Gate <br />access roadway, or a driveway or road that serves more than a single home/duplex? <br />9. <br />Methane - Is project located in or less than 100' from a "Division of Oil, Gas, and Geothermal <br />*(PR160) Residential Site <br />Resources" (DOGGR) field boundary or well (active or abandoned), less than 300-feet from an oil/gas <br />*(PR172-174) Methane <br />seep, or less than 1000-feet from a landfill? (Note: For projects in Yorba Linda, this requirement only <br />Test/Mitigation Plans <br />applies to new homes, enclosed accessory structures, addition to existing structure greater than 1000 <br />sf, and ADU's). <br />10, <br />❑ <br />Iji <br />Vegetation - Is the property/structure (A) on the perimeter of a community containing, or adjacent to <br />*(PR125) Fuel Modification <br />+`- <br />slopes or hills, or (B) adjacent to an open space or wildland area containing non -irrigated vegetation, <br />(PR182) Accessory <br />or (C) in a State Responsibility Area or Local Responsibility Area "Fire Hazard Severity Zone", as <br />Structure <br />defined by the State, or D near an area that could be affected by a wildfire in the open space. <br />-UL;t-A approval required before Issuance of a grace ngibullding permit All other plans types may be deterred submittals. <br />Applicant Certification <br />certify, under penal of er urya, a�der the laws of the State al' ta, t at t information above is true: <br />Print Name: Signature: o !� Date: Vol a-s <br />Phone Number:_71`1 Tom'CC) 2 (S 3 Email: V'Ic-O Y@M -2) al <br />Attention Building Department Staff - After you've verified all questions were answered accurately as "No", then you may accept this sign-eform as a <br />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. <br />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" <br />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 <br />Form (on the reverse), to be submitted along with the appropriate plans to OCFA for a determination. <br />For questions and submittal information, please visit ocfa.org, or call OCFA at (714) 573-6100 <br />