HomeMy WebLinkAbout101107043 - PermitPlanning & Euilding Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
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A. PURPOSE OF THIS DOCUMENTATION 'rherk orr,.rl
! finalng of unreasonable hardship for proiects UNOER the valuation threshold'
! finding of unreasonable hardship for proJects OVER the valuation threshold'
E Certificatron of Full Compliance with the 2019 Califomia Building Code
, Vatuation threshold as defined in the 20'19 California Building Code, Section 1'18-202.4 (Exception #8) and
Section 202 is i12241899 (as of January 2021 )
B. PROJECT INFORMATION TO BE COMPLETED BY PETITIONER:
l. The cost of all construction contemplated in the determination of the valuation of improvement threshold
based on the valuation of site and building improvements for the last three-year period'
DISABLED ACCESS COMPLIANCE
DOCUMENTATION FORM
Permit No Valuation of lm ments
tol i'+ o4z -tp',.Airyt it{ bon
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it{. L ooTotal
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4. Describe the impact of the propo rmproveme on financi I feasibility of the project.
$
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Permrl Number
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Propcl Address
y; Stb
Floor Number
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Business Phone Numb€r
7Ll-Lsr -!{oofhBusrness Name /
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Phone Number-1rtdrr;s tdeLegal Properly
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Cosl of Providing ComP ete Drsabled Accesstn/ction Cost or Pro,ect Valuation
boo$jTotal
5 Describe the pro osed im ents related to accessibility u rades on this ect
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Rev 0t20i2021
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Page 1 of 2
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2. ?0o/o of folal Construction Cost or Project Valuation:
3. The actual amount to be spent to provide disabled access:
lssuance Date
6. ldentify the accessibility features and equivalent facilities that I4tt be brought into compliance with the
latest edition of Title 24 as a part of this project and an estimate of the cost of each item: (Documentation
may be required)
Cost of lmprovement
a. Entrance: kp\or-t ; 3]6-S-4
$ lOrooo
b. Path of Travel
! Path of travel from accessible parking to the building entrance
and area of remodel
e
Path of travel to sanitary facilities / public phone / drinking
fou ntain s 24.Ooa
! Path of travel from the public way to the building entrance s
c Sanitary facilities ( Floor no. I l \. )$ [-[, 60o
d. Public phone(s)5
e Drinking fountain(s)$ t, oog
f. Parking S
g. Signage & Alarms s
i. Other:S
$ f7. oooTotal:
7 ldentify the accessibility features that wLL Nor comply if a request for unreasonable hardship is
granted. Provide an estimated cost of compliance for each item: (Documentation may be required)
Accessible Features Not to be lmproved Cost of lmprovement
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b
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$
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Total:
! Legal Property Owner frArchitecVEngineer nContractor IOther
Print Name otfl |rl /4,4^l Phone No 3to -'lLz - z-?oo
Address eo €.Q{,-,(ti)(9D A 4oloz
Signature Date E'lz-zuz
Approved by
Rev O5t20t2021
FOR AGENC Y USE ONLY
Date L
Page 2 of 2
Accessible Features to be Made Accessible
E Ooor E Landing ! Srairway/Steps ! Ramp
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8. Petitioner must be the legal property owner or his/her legal representative:
I certify that the above noted information is true and correct