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6 ldentify the accessibility features and equivalent facilities that Wltt 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 />Accessible Features to be Made Accessible Cost of lmprovemsnt <br />a. Entrance <br />E ooor n Landing E Stairway/Steps ! Ramp $ <br />b. Path of Travel <br />! Path of travel from accessible parking lo the building entrance <br />and area of remodel $ <br />E Path of travel to sanitary facililies / public phone / drinking fountain $ <br />E Path of travel from the public way to the building entrance $ <br />c. Sanitary facilities ( Floor no )$ <br />d. Public phone(s)$ <br />e Drinking fountain(s)$ <br />f. Parking $ <br />g. Signage & Alarms $ <br />i. Other:$ <br />$Total: <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 item: (Documentation may be required) <br />Cost of lmprovement <br />a $ <br />b $ <br />c.$ <br />$Total: <br />Print Name LAE PhoneNo. lst-ti{-2q1 <br />Address 7?-or 6 . \r\rEjtriJ ?Mr rj^Jrf U A{tulern <br />I aDate: a ISignature <br />Approved by <br />Rev: 1/9/2017 <br />FOR AGENCY USE ONLY <br />Date 1-lr-z- <br />Page 2 ol2 <br />Accessible Features Not to be lmproved <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 />E Legal Property owner ! ArchitecuEngineer EliContractor E other: