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HomeMy WebLinkAbout101107142 - PermitPlanning & guilding Agency Building Safely Oivision 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, C492702 (714) 647-s800 www.santa-ana.org DISABLED ACCESS COMPLIANCE DOCUMENTATION FORM ACC-o'| CBC 2016 [l Finding of unreasonable hardship for projects UNDER the valuation threshold' E Finding of unreasonable hardship for projects OVER the valuation threshold* n Certification of Full Compliance with the 2016 California Building Code ' Valuation threshold as defined in the 2016 California Building Code, Section 118-202.4 (Exception rl8) and Section 202 is $156.162 (as of January 20171 B. PROJECT INFORMATION TO BE COMPLETED BY PETITIONER: Project Address: l@ e.5'( qerTKVPE?L. r^trA*ll.,b Permil Number: lotto'1 l4t Project Description: AIC vrttt Fe?L$enEtrt,T- ghP (P1 4Nt1 PefA( Floor Number:.) Busioess Name / Ownerl Ne c QPovr, Le c Business Phone Number:q+ q 3l I rlo <'' Legal Property Owner: NEC Avoe?. Lvc Phone Number:q4q tz6llor Total Construclion Cost or Projecl Valuation $ /lz,ovtt 1. The cost of all construclion 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. Permit No lssuance Date Valuation of lmprovements Total 2. 20o/o of f ol€l Construction Cost or Project Valuation: 3. The actual amount lo be spent to provide disabled access s I 6,4*o - $ 4. Describe the impact of the proposed improvements on financial feasibility of the project. I Jo". l"^ a,lh 5. Describe the nature of the use of the facility under construction and its availability to persons with disabilities and the nature of accessibility that would be gained or lost: Rev 11912017 -,-SANTA ANA,'Iiiil A. PURPOSE OF THIS DOCUMENTATION: (check one) Cost ol Providing Complete Oisabled Access: $ Page 1 of 2 6. ldentify the accessibility features and equivalent facilities that WILL be brought into compliance with the latest edition of Title 24 as a part of this project and an estimale of the cost of each item: (Documentation may be required) Accessible Features to be Made Accessible Cost of lmprovement a. Entrance EI Door E Landing n Stairway/Steps E Ramp $ /,ooo b. Path of Travel E Path of travel from accessible parking to the building entrance and area of remodel $ Ef Path of travel to sanitary facilities / public phone / drinking fountain $ /, auo n Path of travel from lhe public way to the building entrance $ c Sanitary facilities ( Floor no ) c d. Public phone(s)$ e Drinking fountain(s)$ $ g. Signage & Alarms $ /avo i. Other:$ $Total: 7. ldentify the accessibility features that WILL NOT comply if a request for unreasonable hardship is granted. Provide an estimated cost of compliance for each ilem (Documentation may be required) Accessible Features Not to be lmproved Cost of lmprovement a $ b $ c $ $Total: 8. Petitioner must be the legal property owner or his/her legal representative: I certify that the above noted information is true and correcl. E Legal Property Owner E ArchitecuEngineer E Contractor E other: Print Name: H a", Clre-ol h ut n k- Phone No.>l 3 >to 6lEs Address: 28 R;)bl-C+. PancLo 74,s Signature:Date 275 >.ara4 Rev:1l9l2o1l Date: Page 2 ol 2 f. Parking ,t FOR AGENCY USE ONLY Approved by: