Get Dsa Form 810

COMMENTS note deficiencies DSA 810 rev 05-12-14 DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES Page 1 of 1 STATE OF CALIFORNIA. For additional information see DSA 810 Instructions and DSA Policy 09-01. PROJECT INFORMATION School District/Owner Project Name/School Project Address LFA Agency Name LFA Reviewer Name Title Email Telephone Number I have reviewed and responded to the applicable items for this project as listed below. LOCAL FIRE AUTHORITY REVIEW To facilitate the Division of the State Architect s DSA approval of the Fire/Life Safety portion of a project DSA requires Local Fire Authority LFA review of certain elements as identified in this form* Use of this form is mandatory for projects that add square footage to a campus or if any item on this form is relevant to the project. Note Only sign this form when it is imaged onto the site plan* A loose form is not acceptable to DSA. LFA Reviewer s Signature Date Review Key Y Complies with LFA requirements NA Not applicable to the project N Not approved complete Section 8 NR LFA elects not to review Description NA NR Access roads fire lane markings pavers and gate entrances are in accordance with Title 19 California Code of Regulations and the California Fire Code Chapter 5. N Where an elevator does not meet medical emergency service cab size per the California Building Code CBC use of stairways for emergency rescue and patient transport is acceptable. Y Fire hydrant location and distribution complies with the California Fire Code or see 4. checked DSA can only approve on-site water storage as an alternate. The signature of the school district official is required to acknowledge the use of alternate means. Signature of School District Official Date Print the School District Official s Name The location s of the proposed post indicator valve and fire department connection meet the requirements of this jurisdiction* jurisdiction* Is the project located in a hazard severity zone area CBC Chapter 7A Section 701A. Yes No Check type if Yes Moderate High Very High WIFA If one of these boxes is checked the project design must meet the requirements of Chapter 7A. Note Only sign this form when it is imaged onto the site plan* A loose form is not acceptable to DSA. LFA Reviewer s Signature Date Review Key Y Complies with LFA requirements NA Not applicable to the project N Not approved complete Section 8 NR LFA elects not to review Description NA NR Access roads fire lane markings pavers and gate entrances are in accordance with Title 19 California Code of Regulations and the California Fire Code Chapter 5. LFA Reviewer s Signature Date Review Key Y Complies with LFA requirements NA Not applicable to the project N Not approved complete Section 8 NR LFA elects not to review Description NA NR Access roads fire lane markings pavers and gate entrances are in accordance with Title 19 California Code of Regulations and the California Fire Code Chapter 5. N Where an elevator does not meet medical emergency service cab size per the California Building Code CBC use of stairways for emergency rescue and patient transport is acceptable.