HomeMy WebLinkAbout104106720 - Permit (2)n 0,sAl{lA
ANA,ffi
Planning & Building Agoncy
Bullding Safoty Olvlslon
20 Civlc Conter Plaza
P.O. Box 1988 (M.19)
Santa Ane, CA 92702
(71lt) 6,17*5800
www,t a nta .a n a. org
DISABLED ACCESS COMPLIANCE
DOCUMENTATION FORM
ACC-o1 CBC 2019A. PURPOSE OF THIS OOCUMENTATION: r;heck ore,
! Finding of unreasonable hardship for projects UNDER the valuatron threshold'!Finding of unreasonable hardship for proiects 0VER the valuation threshold"
Certrficatron of Full Compliance with the 201 9 Cahfornia Burtding CodeF
' Valualion threshold as deflned in the 2019 California Buildrng Code. Section 1 1B-202 4 (Exceplron #81 and
Secrron 202 is $170,466.00 (as of January 2O2O )
B. PROJECT INFORMATION TO BE COMPLETED BY PETITIONER:
r"?lH;,,. ft:vers sr PermrlNumcer
PaoJecl Descfiplron
Detlo t/v Per2.vvlrrfrZn Ar4LLSI 4Ecf met Brtsanda de5T
Busrness Name / Owner Busrness Phone Number3\ AAPY"AaET\ta{r 9{1 -'t zz 'lttoo
Legal Properly Ow erC*At€ HaeDtilGg
Tolal Conslruclron Cosl or Project Veluatrons t2oo-
gArA€
Cosl ol ProvidxU Complete Orsabled Access
S 710
The cost ot ali constructron contemplated in the delermination 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 lm ovem e ntstLoo-
2 20'/o of T olal Constructron Cost or Project Vatuation
3 The actual amount to be spent to provide disabted access
S 71o
2'lO
4 Descflbe the rmpact of the oposed improvements on financtal feasrbrlity of the project
t"rrLL PA\/r o€ ./POAr€'O D.lrTL
T DNDft\tc,Nft L1€ €\r{t 6stt- Crstn Ptt fH LE
s
Rca 02104t2021)
L +LLq,L€
Paqe 1 ol 2
29
Total lzo>
5 Descnbe lhe nature of the use of the facility under construction and its avarlability to persons with
drsabrlitres and the nature of accessibrlity that would be gained or lost
5 ldentify the accessrbrlrty Features and equrvalent facrlrtres that W!!lt be brought rnto comptrance wrth the
latest editlonof Title24 asa partof thrsprolect andanestrmateof thecost ofeach rtenl (DocuDEnta/ia/)/ ay be requ//e(/l
Accossible Featuros to bo Mado AccosBlblo Cost of lmprovomont
a Enlrance
E Door D Landrng ! Stairway/Steps D Ramp )
b Path of Travel
D Path of travel from accessrble parkrng to lhe burlding entrance sand area of remodel
Path of travel to sanrtary Facrlitres / pubtrc phone i dr ink rng
founlarn
E Path of travel from the publrc way to the burldrng entrance )
c. Sanitary faciljties (Floor no S
d Public phone(s)
e Dflnkrng fountarn(s)5
f Parking J
g Srgnage & Alarms $ 210
i Olher )
Tot l: S
ldentrfy the accessrbrlrty Features that wlLL ilor comply if a requesl for unreasonable hardshrp rs
granted Provrde an eslimated cost of compliance for each item (Docunrc/tlahon nzy be reqt/lred)
Acc6sslblo Featuros llot to bo lmprovod Cost of lmprovemont
a tl-:we a-ah+ig,/L-$ jir:ooD -
b
C
Total:s ?t0 ooo
8. Potltloner must be the legal property owner or hle/her legal reprerentaUvo:
icertify lhat the above noted rnformalion is kue and correct
E Legal Property Owner ! ArchitecvEngineer ! Contractor p.Other LDr'!t\, wlCll-
Pflnt Nan]e
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Address
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Date 2l
Approved by
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FOR AGENCY USE ONLY
Date
Page 2 o12
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