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VIRP
<br />,GE COG` ORANGE COUNTY FIRE AUTHORI'
<br />Plan Submittal Criteria Form
<br />Required for Single Family or Duplex Residences
<br />�r r11OR'� (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 App
<br />Project Information
<br />❑ New Single Family Residence/Duplex ❑ Addition/Remodel [l3' ADU
<br />Address:
<br />24021 Via La Coruna
<br />CITY OF SANTA ANA
<br />Planiiing and Building Agency
<br />SFR
<br />Approved
<br />FOR PERMIT ISSUANCE
<br />I Certification.
<br />Master ID:
<br />Date:
<br />❑ Other
<br />Unit #: City or Unincorporated County Area: ZIP:
<br />Mission Viejo 92691
<br />Scope of Work: New 599 Sf detached ADU with 1 bedroom, 1 bathroom, laundry, kitchen, living room, 48 sf porch
<br />ExistingArea to Total Resulting Stories: Area Added in Past 2 Years
<br />Area: 2164 g be Added: 599 Area: ���� 1 (excludinq this project): O
<br />Yes No
<br />Questionnaire
<br />OCFA Plan Type if "Yes"
<br />1.
<br />❑
<br />0
<br />New — Is this a new single family residence or duplex?
<br />*(PR160) Residential Site
<br />with Water Availability
<br />PR400-402 Fire S rinkler
<br />2.
<br />❑
<br />R1
<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 />fire sprinklers or a house that will have fire sprinklers added as part of this project?
<br />3.
<br />Ei
<br />9
<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 />EI
<br />®
<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 (so 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 />®
<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 />❑
<br />10
<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 />Rj
<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 />❑
<br />®
<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 />0
<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 />'0(;FA approval required betore issuance of a grading/building permit. All other plans types may be deterred submittals.
<br />Applicant Certification
<br />I certify, under penalty of perjury, under the laws of the St�ifo
<br />at the information above is true:
<br />Print Name: THINH NGUYEN Signature: Date: 12/29/2023
<br />Phone Number:714-855-0820 Ema�H@TND-STUDIO.COM
<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) 573-6108
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