Form DSA 810 PDF Details

The DSA 810 form plays a critical role in ensuring the safety of construction projects within school campuses by requiring a Local Fire Authority (LFA) review to approve the Fire/Life Safety aspects. This mandatory requirement aims at enhancing project safety standards, especially for those that expand the campus square footage or engage specific elements listed within the form. Detailed project information, including the school district or owner details, project name, and address, allows for a thorough review by the appointed LFA agency. The form encompasses a structured review process, listing conditions such as elevator emergency service capabilities, access road compliance, and fire hydrant distribution, to name a few, all aimed at aligning with strict regulations set by the California Building Code and the California Fire Code. This review process not only necessitates the LFA reviewer's confirmation on compliance with applicable standards through a signature but also underscores the importance of official acknowledgment from school district officials for any alternate means employed. Additionally, it assesses project location concerning hazard severity zones, demanding adherence to specific requirements for such areas. Overall, the DSA 810 form serves as a vital tool for collaborating with local fire authorities to ensure construction projects meet essential safety regulations, promoting a collaborative approach to construction safety and regulation compliance.

QuestionAnswer
Form Name Form DSA 810
Form Length 4 pages
Fillable? Yes
Fillable fields 40
Avg. time to fill out 9 min 4 sec
Other names dsa form 810, California, pavers, 701A

Form Preview Example

810

LOCALFIREAUTHORITYREVIEW

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. For additional information, see DSA 810 Instructions and DSA Policy 09-01.

PROJECT INFORMATION

School District/Owner:

Project Name/School:

Project Address:

LOCAL FIRE AUTHORITY (LFA)

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.

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

“N” = Not approved (complete Section 8)

 

 

 

 

 

 

 

“NA” = Not applicable to the project

“NR” = LFA elects not to review

 

 

 

 

 

 

 

 

 

 

 

Description

 

 

Y

N

NA

NR

 

 

1

 

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.

 

 

 

 

 

 

 

 

 

 

 

2

 

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

Fire hydrant location and distribution complies with the California Fire Code (or see # 4).

 

 

 

 

 

 

 

 

Fire hydrant location and distribution complies with NFPA 1142, “Alternate Means.” If “NR” is

 

 

 

 

 

 

 

 

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.

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of School District Official: ________________________________________Date:____________

 

 

 

 

 

 

 

 

Print the School District Official’s Name:_______________________________________________________

 

 

5

 

The location(s) of the proposed post indicator valve and fire department connection meet

 

 

 

 

 

 

 

the requirements of this jurisdiction.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

The location(s) of the detector check valve assembly meet the requirements of this

 

 

 

 

 

 

 

jurisdiction.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the project located in a hazard severity zone area? (CBC, Chapter 7A, Section 701A.)

Yes

No

 

 

7

 

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.)

 

 

 

 

 

 

COMMENTS (note deficiencies):

 

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DSA 810 (rev 05-12-14)

 

Page 1 of 1

DIVISION OF THE STATE ARCHITECT

DEPARTMENT OF GENERAL SERVICES

STATE OF CALIFORNIA

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Step 1: Just press the "Get Form Button" in the top section of this site to open our pdf editor. This way, you'll find all that is necessary to work with your file.

Step 2: As soon as you access the file editor, you'll see the document made ready to be filled out. Apart from filling out various fields, you might also perform several other actions with the Document, particularly writing any textual content, changing the original text, adding images, signing the document, and a lot more.

Pay close attention when filling in this pdf. Make certain all necessary fields are filled in properly.

1. It's important to complete the LFA correctly, thus pay close attention while working with the parts including all of these blanks:

DSA-810 conclusion process clarified (part 1)

2. Right after filling in this section, head on to the subsequent stage and fill in the essential particulars in all these blank fields - LOCAL FIRE AUTHORITY LFA LFA, Description, Where an elevator does not meet, Y N NA NR, Signature of School District, Print the School District, and Yes.

The best way to fill out DSA-810 portion 2

Always be really attentive when completing Y N NA NR and Signature of School District, because this is the section in which most people make mistakes.

3. The following step is mostly about Print the School District, Very High, Moderate, WIFA, Yes, High, DSA rev DIVISION OF THE STATE, DEPARTMENT OF GENERAL SERVICES, and Page of STATE OF CALIFORNIA - fill out each of these blank fields.

Filling in segment 3 of DSA-810

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