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FIRE <br />ORANGE COUNTY FIRE AUTHOI <br />_ Plan Submittal Criteria Form <br />qRt� �a�r naon�t 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 />F <br />CITY OF SANTA ANA <br />Planning and Building Agency <br />Y Pr d <br />FOR CE <br />Master ID: <br />Date: <br />LI ivavv aulymc ranuly nue;luencervuplex u Addition/Remodel 9k ADQ ❑ Other <br />Address: �11 I `'� Unit #: City or Unin rporat d County Area: ZiP: <br />Scope of Work: <br />Existing '�()li; Area to Total Resulting jp �l Stories: Area Added in Past 2 Years <br />Area I �"" be Added: Area: ' G4 <br />(excluding this project <br />Yes No Questionnaire nr•rn 01-- T... ;f <br />1. <br />® <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 />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 />firesprinklers or a house that will have firesprinklers added as part of thisproject? <br />3. <br />❑ <br />M <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 />s rinkler retrofit based on a threshold set by local ordinance? <br />4. <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 />❑ <br />JQ <br />Remodel — Is this a remodel of a sprinklered building with a scope of work that includes adding or <br />(PR400-402) Fire Sprinier <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 />❑ <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 />0 <br />Iltl <br />Gate — Is a gate being installed across a driveway or road that is designated as a fire department <br />(PR180) Gate <br />JI <br />access roadway, or a driveway or road that serves more than a single home/duplex? <br />9. <br />® <br />P, <br />Methane — Is project located in or less than 1 00'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 />*(PP172-174)With— <br />seep, or less than 1000-feet from a landfill? (Note: For projects in Yorba Linda, this requirement only <br />Test/Midgation 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 />Vegetation — Is the property/structure (A) on the perimeter of a community containing, or adjacent to <br />*(PR125) Fuel Modification <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 />uF tj vvai -cyuu uu uvivi o i�uai ivv Ul a yl aUll Iy/t.JUJ1U11 ly pC1I I IIL HII Uu iei puns types may oe aererrea suomaa s- <br />Applicant C ficatio <br />t_cgrtify, undef penalty of perjury, under the i ws th _ f Cal om , tit the information above is true: r <br />Print Name: Vf/W IV V1 i Si ature. ) Date: 19 111 1�:2-lf <br />Phone Number: mail: maA <br />Attention Building Department Staff — After you've verified all questions were answered accurately as "No", then you may accept this signed form 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 />