Project Address: 123 Hope Street Application No. YL-0000000
Project Description/Location: Office tenant improvement (2,040 SF) at 5th
floor Suite No. 502
Type: Alteration ☐ Structural Repair ☐ Addition
Permit Valuation: $180,000.00
*Adjusted Cost of Pro
posed Construction: $144,000.00
PATH OF TRAVEL REQUIREMENTS FOR AREA OF ALTERATION, STRUCTURAL REPAIR, OR ADDITION
Accessible Features
Does existing feature meet
accessibility standards of Chapter
Will this feature be replaced or
altered to meet Chapter 11B of
If so, how much will be spent
to make this feature
1 Accessible entrance NO YES $ 2,400.00
2 Accessible route to the altered area NO PARTIAL $26,000.00
3 Accessible restroom for each sex
serving the area
NO YES $ 8,000.00
4 Accessible telephones N/A N/A
5 Accessible drinking fountains N/A
6 Other (Any of the below)
A. Accessible parking spaces NO YES $ 1,100.00
B. Signs NO
C. Alarms N/A
D. Other:
Cost of All Features Provided (A) Summary of costs of Accessible Features Nos. 1-6 provided above. $37,500.00
Total Cost on Same Path of Travel (B ) Cost of Proposed Construction and Cost of Preceding Alterations. $144,000.00
Percentage Upgrades Provided (A / B) Cost of all Features Provided / Total Cost on Same Path of Travel. 26%
Description of Access Features Provided:
New entrance landing, new accessible fixtures for the restrooms, properly mark and identify the accessible parking area, and 27 cubic yards of concrete
(289 feet of sidewalk)
Hardship Request: 345 lineal feet of exterior sidewalk that exceeds 2.08% cross slope which is 3.4% - 3.8%. Without this request approval the
project will not be able to happen due to lack of finances. Please see attached implementation plan and my justification for approval.
Applicant Certification
I certify that the above information is true and correct to the best of my knowledge and belief.
Signature:
John Smith
Date: 09 /12/2014 Company: Johns’ Smithing & Wesson
Name: (print) John Smith Address: 123 Broadway
Title: Architect of Record City, State Zip: Oroville, CA, 95965
Agent for:
Owner Architect ☐ Engineer ☐ Contractor
Phone No.: 530-000-0000
For Building Official Use Only
Approved by: Title: Date: / /
*If an area has been altered without providing an accessible path of travel to that area, and subsequent alterations of that area or a
different area on the same path of travel are undertaken within three years of the original alteration, the total cost of alterations to the
areas on that path of travel during the preceding three-year period shall be considered in determining whether the cost of making that
path of travel accessible is disproportionate.
CITY OF YORBA LINDA
4845 CASA LOMA AVENUE YORBA LINDA, CALIFORNIA 92886
BUILDING DIV
ISION (714) 961-7120
Example Form for Summary of Upgrades for Projects Not Exceeding $170,466.00
REVISED 05/10/2019 Page 2
