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6. ldentify the accessibility features and equivalent facilities that WILL be brought into compliance with <br />. the latest edition of Title 24 as a part of this project and an estimate of the cost of each item: <br />, (Documentation may be required) <br />I Accessible Features to be Made Accessible Cost of lmprovement <br />a. Entrance <br />n Door E Landing I Stairway/Steps n Ramp $a <br />b. Path of Travel <br />E Path of travel from accessible parking to the building entrance <br />and area of remodel $o <br />E Path of travel to sanitary facilities / public phone / drinking fountain $o <br />E Path of travel from the public way to the building entrance s o <br />c. Sanitary facilities ( Floor no )$d <br />d. Public phone(s)s0 <br />e Drinking fountain(s)$0 <br />$0 <br />g. Signage & Alarms $0 <br />Other: -ii.,tn-co,/pC/ D"ntt t ><*o <br />$ 4!*tTotal: <br />7. ldentify the accessibility features that WILL NOT comply if a request for unreasonable hardship is <br />granted. Provide an estimated cost of compliance for each ilem (Documentation may be required) <br />Accessible Features Not to be lmproved Cost of lmprovement <br />S <br />b s <br />c $ <br />sTotal <br />8. Petitioner must be the legal property owner or his/her legal representative: <br />I certify that the above noted information is true and correct. <br />! Legal Property Owner f] ArchitecUEngineer E Contractor E other: <br />Print Name: V' t K Zr Phone No /4 <br />'{rr 9 a.tk l) <br />4.. <br />t){- J-7/f <br />Address: <br />Signature <br />tl <br />Date: )>l <br />Rev: 1/9i 2017 <br />Kf^Date <br />Page 2 ol 2 <br />aApproved by <br />I <br />I <br />I <br />f. Parking <br />I <br />Anuit <br />I <br />FOR AGENCY USE ONLY <br />a