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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 />DISABLED ACCESS COMPLIANCE <br />DOCUMENTATION FORM <br />SANIA <br />tl.t\ll\c <br />J[Uur\G <br />tcilflANA <br />flil 0r <br />ACC.O1 CBC 2015 <br />A. PURPOSE OF THIS DOCUMENTATION: (check one) <br />! Finding of unreasonable hardship for prqects UNDER the valuation threshold* <br />! Finding of unreasonable hardship for prqecb OVER the valuation threshold' <br />Eacertification of Full Compliance with the 2016 Califomia Building code <br />. Valuation threshold as defined in the 20'16 Califomia Building Code, Section 1'l8-202.4 (Exception #8) and <br />Section 202 is $lsga!g? (as ofJanuary 2017) <br />B. PROJECT INFORMATION TO BE COMPLETED BY PETITIONER: <br />Project Address:h Ut SA*tr+ AJr -Oerrr. Srr l?f Permil Number: <br />\o \ \ o31iz- <br />Project Description: <br />lfurf ,nmo.t*ol <br />Floor Numberl L <br />Business Name / owner: <br />c,CldJW Catn'1 tltm* C42( <br />Business Phone Number:2t./ PSn r'/((, <br />Legal Property Owner:M* u*rre Phone Number:1n 267 1,(^ <br />Total --onstruaion eoit or Project valuation:' <br />$ <br />Cosl of Providing Complete Disabled Access: <br />$ <br />The cost of all construction contemplated in the determination of the valuation of improvement <br />threshold based on the valuation of site and building improvements for the last three-year period. <br />Permit No Valuation of lmprovements <br />Total <br />2. 20yo otf01€] Conslruction Cost or Pro.lect 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 />5. Describe the nature of the use of the facility under construction and its availability to persons with <br />disabilities and the nature of accessibility that would be gained or lost: <br />s <br />$ <br />Rev: 1/9/2017 Page 1 ot 2 <br />lssuance Date