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<br />Rev: 02/01/2023 Page 1 of 2 <br /> <br /> <br /> <br />DISABLED ACCESS COMPLIANCE <br />DOCUMENTATION FORM <br /> <br /> <br />ACC-01 CBC 2022 <br />A. PURPOSE OF THIS DOCUMENTATION: (check one) <br /> <br /> Finding of unreasonable hardship for projects UNDER the valuation threshold* <br /> Finding of unreasonable hardship for projects OVER the valuation threshold* <br /> Certification of Full Compliance with the 2022 California Building Code <br />* Valuation threshold as defined in the 2022 California Building Code, Section 11B-202.4 (Exception #8) and <br />Section 202 is $195,358.00 (as of January 2023) <br /> <br />B. PROJECT INFORMATION TO BE COMPLETED BY PETITIONER: <br /> <br />Project Address: <br /> <br />Permit Number: <br /> <br />Project Description: <br /> <br />Floor Number: <br />Business Name / Owner: Business Phone Number: <br />Legal Property Owner: Phone Number: <br />Total Construction Cost or Project Valuation: <br />$ <br />Cost of Providing Complete Disabled Access: <br />$ <br /> <br />1. The cost of all construction contemplated in the determination of the valuation of improvement threshold <br />based on the valuation of site and building improvements for the last three-year period. <br /> <br />Permit No. Issuance Date Valuation of Improvements <br /> <br /> <br /> <br /> Total: <br /> <br />2. 20% of Total Construction Cost or Project Valuation: $ <br />3. The actual amount to be spent to provide disabled access: $ <br />4. Describe the impact of the proposed improvements on financial feasibility of the project. <br /> <br /> <br /> <br /> <br />5. Describe the proposed improvements related to accessibility upgrades on this project. <br /> <br /> <br /> <br /> <br />Planning & Building Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />1011204140 <br />MEDICAL INTERIOR ALTERATION 1 <br />SIMONMED IMAGING 866-614-8555 <br />iMedical Holdings 714-874-4441 <br />150,000 <br />1401 N TUSTIN AVE, STE 170, SANTA ANA, CA 92705 <br />0 <br />101120140 150,000 <br />150,000 <br />30,000.00 <br />0 <br />NO IMPROVEMENTS ARE PROPOSED <br />NO IMPROVEMENTS ARE PROPOSED. ACCESSIBLE PATH OF TRAVEL <br />IMPROVEMENTS WERE ALREADY MADE IN 2022, WITH PERMIT NUMBER <br />101112870. A COPY OF THOSE PLANS IS SUBMITTED HEREWITH FOR <br />REFERENCE <br />TBD <br />**THE DEMISED UNIT IS IN COMPLIANCE WITH CHAPTER 11B OF THE CBC <br />** <br />1401 N Tustin Ave Unit# <br />170 - TI1/27/2025