Rolling Oaks MC-CS090429TEXAS DEPARTMENT OF LICENSING AND REGULATION
COMPLIANCE DIVISION - ARCHITECTURAL BARRIERS
P.O. Box 12157 • Austin, Texas 78711 • (512) 463 -3211 • (877) 278 -0999 • FAX (512) 475 -2886
arc hil.eettiral.ba rr iers t license.state.tx.tis e www. l
REQUEST FOR INSPECTION
In accordance with the Texas Architectural Barriers Act, Texas Government Code, Chapter 469, and Administrative Rule 68.52, the
owner of a building or facility subject to Chapter 469.101 of the Act shall obtain an inspection from the department, a registered
accessibility specialist, or a contract provider not later than the first anniversary of the completion of construction.
The request for an inspection must be made by completing this form and submitting it to the department, a registered accessibility
specialist, or contract provider not later than 30 calendar days after the completion of construction. If the Request for Inspection
form is submitted to the Department, the form must be accompanied by the applicable
inspection fee.
The department, a registered accessibility specialist, or a contract provider must receive the completed Request for Inspection form
prior to proceeding with the inspection. Following the inspection, the owner will be advised in writing of the results.
PROJECT INFORMATION
PLEASE PRINT O TYP
1. Project Name: Rolling Oaks Memorial Center
2. EABPRJ #: A8809546
3. Project Address: 400 S. Freeport Parkway
Suite #:
City: Coppell
County: Dallas
Zip: 75019
OWNER / AGENT INFORMATION
(Check One) I am 2 the Owner (the person /entity that holds title to the property) or ❑ the Owner's Auent
4. Name: Mike Garza
5. Company/ Agency: City of Coppell v
6. Address: 255 Parkway Blvd
Suite #
City: Coppell
State: Texas
Zip. 76019 -9478
7. Phone: 972.462.0022
8. Fax:
9. " Email:
t il ts) D
0. of Owner/Designated Agent
I Date
I have authorized the following to perform the inspection (Check One)
❑ Texas Department of Licensing and Regulation
❑ Contract Provider
Cpl Registered Accessibility Specialist RAS# 0291 RAS Name Martin Mullins
TDLR FORM ABO41 03 -07 NOTE: An individual who completes and riles this form with the Texas Department of Licensing and Regulation (the Dept.) is entitled to the following
1) to be informed about the information that the Dept collects about the individual, upon their request and subject to a few exceptions;
2) to receive and review the information, under Sections 552 021 and 552.023 of the Texas Govt. Code, and
3) have the Department correct information about the Individual that Is incorrect, under Section 559.004 of the Texas Govt. Code.
"fhe Department will add your address to the Architectural Barriers email notification list, which automatically provides information from the Department on matters affecting Architectural Barriers.
Your email address is confidential pursuant to the Texas Public Information Act and the Department will not share It with the public. See additional information at the following iink
ttp
h.Rwww.hcense st at e,Ex.us/i)ewslettersdTDLRnotificationL,sts. asp
Page 1 of 1
Michael Garza - Rolling Oaks
From:
<texasability(a),att.net>
To:
<mgarza(aci.coppell.tx.us>
Date:
4/29/2009 12:23 PM
Subject:
Rolling Oaks
Mike,
I haven't received the Request for Inspection Form yet. I'm required to have it prior to the inspection.
Thanks,
Marty
A. Martin Mullins, I11, LC, RAS, LEED AP
Registered Accessibility Specialist
TDLR License # 0291
TexasAbility, LLC
P.O.Box 729
Gun Barrel City, Texas 75156
Cell: 214.532.0386
texasability(a, att.net
file://C: \Documents and Settings \mgarza \Local Settings \Temp \XPGrpWise \49F846D2City... 4/29/2009
TexasAbility
Design • Plan Review • Inspection
P.O. Box 729
Gun Barrel City, Texas 75156
(903) 288 -2962
TexasAbility@aft.net
April 13, 2009
Mike Garza
City of Coppell Texas
255 Parkway Boulevard
Coppell, TX 75019 -9478
RE: AB Project Number EABPRJA8809546
Rolling Oaks Memorial Center Columbarium and Pavilion Buildings
400 S. Freeport Parkway
Coppell, TX 75019 (Dallas Co)
TA# 08005
I N V O I C E
TAS Inspection + mileage $ 545.00
Total Due $ 545.00
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