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Pianning & Buiiding Agency <br />Buiiding and Safety Division <br />20 Civic Center Piaza <br />P.O. Box 1988 (M・19) <br />Santa Ana, CA 92702 <br />(71 4)"647"5800 <br />WWW.Santa"ana.Org <br />DETACHED ADU - <br />GRADING PERMIT EXEMPTION <br />CHECKLIST <br />易国運〇回脚コ岳-∪7宣〇二(霊鳥も珊調脚オばつ○○なおま彊〇〇〇〇〇　　　　臆　　　　　　　　　　　　　　　　　　￣￣￣￣￣￣￣￣￣ ￣ ￣　　　　こさず〇〇°二°"お「○○教“○○00-臆臆　　　　　　　　臆臆臆臆臆臆臆 <br />PCC-16 <br />THiS FORM SHALL BE COMP」ETED BY A CALIFORNiA REGISTERED CiVi」 ENGINEER, <br />Instructions: In o「der to qua冊y for the grading permit exemption for defached Accessory <br />Dwe冊ng Unit (ADU) p「Qjects per handout PCC-15, the registered civil engineer of 「e∞rd sha= <br />∞mPiete a= sections, Check a= boxes and sign the cer輔cation section below・ A copy ofthis <br />CheckIist shali be attached to each ofTWO sets of pians」f answerina NO to anv ofthe <br />queStions, a grading permit shalI be reauired. <br />Project Address: <br />Yes No <br />1. 口 □ Ihaveprovidedtwosetsofsitedrainagepiansthatisstamped,Signedand datedbyaCaIifo「niaprofessionaiciviIengineer,tObesubmittedwiththe <br />buiidingsubmittaIpackage. <br />2. 口 □ ihavecalcuIatedthetotaiamountofso=beingcuto「剛edonthisp「QjectisIess <br />than50cubicya「ds, <br />3. 口 □ 丁hesited「ainageplansinciudethefo=owing,butnotlimitedto,Iocationofa= <br />existingandproposedst「uctu「es,PrOPertyiines,rjght-Of-Waylines,and <br />easements,incIudingdimensjonsandsetbacks;d「ainagesIopesandflow <br />PattemS,drainagesystemssuchasswaies,frenchd「ains,Wate「CO=ectionand <br />disposalsystems,etC. <br />4. ロ □ ihavedesig=edd「ai=ageSuChthatsurfecewate「flowsawayf「ombui-dingsand <br />adjoiningp「opertyIines,inacco「dancewitha=app=cabiecodes, <br />5. 口 口 lhavedesignedg「adingsuchthatitw冊otadve「seiyaffecttheadjoining <br />P「OPe巾es. <br />6. 口 口 lhavedesignedtheg「adetofaIinotfewe「than6incheswithinthefirstlOfeet <br />f「omthefoundationwa=s.Whe「eIotlines,Wa=s,SIopeso「othe「physical <br />bar「ie「sp「ohibit6inchesoffa=withinlOfeet,lhavedesignedd「ainso「swaleto <br />ensured「aj=ageaWayfromthestructure・ihavedesignedanyimpervious <br />SurfaceswithinlOfeetofthebuildingfoundationtobesIopednotIessthan2 <br />Pe「CentaWayf「omthebuilding, <br />7. 口 口 IwiIIp「ovideafinaicer珊cationIette「statingthattheg「adeswereconstructed PertheapprovedsitedrainagepIan,andw冊submitthisce輔cationiettertothe <br />buiidinginspecto「p「iortofina=nspection. <br />i certify under penalty of pく河ury under the iaws ofthe State of Califomia that the above is true: <br />P「int Name: <br />Licensed Number: <br />Phone Numbe「: <br />REV: 09/03/2020 <br />Ema= Add「ess: <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />Joanne Singer <br />RCE 26900 <br />206-734-7765 -76-625-7246 <br />5-24-2024 <br />dpatneaude@drpenterprisesllc