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CITY OF SANTA ANA Planning and Building Agency FIFr ORANGE COUNTY DIRE AU'I'IIORIT Plan Submittal Criteria Form Required for Single Family or Duplex Residences �"i!"'_« (Use commetial form for lots With 3+ 6%ell:ng uns or rem residen1i I traUs) Complete the Project Information and Questionnaire kAcPN, then sign and date the Appi Project Information ❑ New Single Family ResidenceiDuplex Y AdditionlRemode1 ❑ ADU d 'FOR P,f T IS UANC Master ID: Address: Un t #: City or Un ncorporated County Area. ZIP. 922 W Park Ln Santa Ana 92706 Scope of Work: ±554 SF ADDITION TO THE HOUSE AND 190 SF FRONT PORCH Existing 153 3 Area to 554 Total Resulting O 8 Stories: 1 Area Added in Past 2 Years O Area be Added: Area exclud,n this ro�ectl: Questionnaire ❑ Other OCFA Plan Type if "Yes" 1. El 0 New — Is this a new single family residence or duplex? .(PR160) Residential Site 1 with Water Availability PR400-401 Fire Sprinkler 2. ® ADU — Is this a new Accessory Dwelling Unit (ADU) on the same property as a house that already has (PR400.401) Fire Sprinkler firesprinklers or a house that will have firesprinklers added as part of this ro�ect? 3. Addition — Is the (A) an addition to a currently sprinklered building, or (B) an addition requiring a fire (PR400-401) Fire Sprinkler sprinkler retrofit based on a threshold set by local ordinance? 4. Q 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. Q Total Area — Will the addition result in a total area of greater than 3,600 square feet (so for non- '(PR160) Residential Site sprinklered buildings, or greater than 6,200 sf for sprinklered buildings, including the area of all with Wa ter Availability enclosed saaces. such as garages, stairs, and detached structures separated by less than 10-feet? 6. ❑ E Remodel — Is th s a remodel of a sprinklered building with a scope of work that includes adding or (PR400-401) 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 garage, workshop, game room, pool house, bam, etc., requiring fire sprinklers based on a threshold (PR40"01) Fire Sprinkler sel b local ordinance? 8. El Q Gate — Is a gate being installed across a driveway or road that is designated as a fire department (PR160) Gate access roadway, or a driveway or road that serves more than a single homefdu lex? 9. Methane — Is project located in or less than 100' from a "Division of Oil, Gas, and Geothermal (PR160) Residential Site "(PR172.174) Resources' (DOGGR) field boundary or well (active or abandoned), less than 300-feet from an oiVgas Methane seep, or less than 1000-feet from a landfill? (Note: For projects in Yorba Linda, this requirement only 7csOlitigaiion Plans applies to new homes, enclosed accessory structures, addition to existing structure greater than 1000 sf, and ADU's). 10. Q Vegetation — Is the property/structure (A) on the perimeter of a community containing, or adjacent to (PR125) Fuel Modircation 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. Uc rH approval regLrrea oeiore ussuarxzt u d yrdumcy/uuuuulg perms. Hi otner pars types may Do aererrea suDmttats. Applicant Certification 1 certify, under penalty of perjury, under the laws of the Sta _of alif rnia,, ,thatthe information above is true: Print Namo KAVJEHI HOLOMALIA Signature TR1C AI �� Date 7/fs Z� Phone Number: 71P —' S Email KEKAN1112299@YAH00.00M 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 st ll requires the applicant to have their plans revlevred 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 deter6nadon. For questions and submittal information, please vis4 ocfa.org, or cal OCFA at (714) 573-61 G9 ----------------------------- Scanned with m CamScanner