SW0501-CS051115 475 2871
NE, -i_,-,~00~ 89:53 T;K DEPT LICENSING 4?5 2871 P.01/05
TEXAS DEPARTMENT OF LICENSING
AND REGULATION
Staci Renee McCOy-Trammell
Licensing Analyst
P O BOX 12157 AUSTIN, TEXAS 7871'1
DIRECT LINE (512) 463-3524 800-803-9202 FAX (512) 475-2871
L
FAX COVER SHEET
NTS:
NOL~-iS 2~L]5 ~9:~%] TX DEPT LICENSING 4?5 2871 P.02/05
ARCHITECTURAL BARRIERS - PROJECT REGISTRATION FORM ......
P.O. BOX 12157, Austin, Texas 78711. (512) 463-659,9. (800) 803-9202' FAX (5~2) 475-287~]~
PLEASE SEE IMPORTANT INSTRUCTIONS BEFORE IBI=GINNIN(~''~'u ~'3 ~
NOTE: A project submittal ia not complete unless an Architectural Barriers Project Registration For q a complete set~L~ar'~m ,,-+~
documents, and applicable fees are submitted to TDLR, a Registered Accessibility Speci ali~F,, or a Contract Provider.
Failure to submit any of these items will delay processing.
Project Name Samuel Bou]eva~ Curb Ramps
2. Building/Facility Name Samuel Boulevard Sidewalk and Curb Ramps (Parkway Blvd. to MacAr~hur Blvd.)
Location/Address Samuel Boulevard
Tenant (if other than owner)
j City Coppell
5. Mailing Address I City
Contact Name
7 Mailing Address J City
8 Buildiag/FacilltyOwner(NOT tenant) City of Coppell
g. Mailing Address P,O. BOx 9478
l City Coppell
10. Contact Name Suzan Taylor
~1. Moiling Address P~O. Box 9478 I City Coppell
12. Design Firm City of Coppell (ImHouse Design)
13 Mailing Address P.O. Box 9478 j City Copp¢ll
Zip Code 75019 j County Dallas
Telephone Number
State J Zip Code
Telephone Number
State
JZip Code
Telephone Number
( 972 ) 304-3679
I ziP Code
State Texas 75019
Telephone Number
( 972 ) 304-7019
State Texas
Telephone Number
( 972 ) 304-3679
Zip Code
75019
ZipCode
State Texas 75019
14. Designer Information:
r.]Architect nlnterior Designer
E]Engineer E]Landscape Architect
[]Other
Print Name: Keith R. Marvin, P.E.
License No. (if applicable) 89388
Date Cor~struction Documents
Issued:
j Schematic Plans
15. Construction Start I 16. Construction Completion 17. Estimated Prelect Construction Cost
D~te (MM/YY): Est. - March 2006 [i Date (MM/YY): Est. - July 2006 ......... $ $72,205.00
~8. Oescrlption:lndicatetypeofworkandbrieflydessrib~scope [3NewConstruction ~Renovation/Alteration nAdditions/Renovati0~s
E3Additio~ to Existing 13trig. E]New Construction/Renovation [3Historic Preservation
Scope of work: __T__hS_r_~_c_°_as__~_Stj_°_~_°_f_~_~_2_xi_sJi_~.~_2~r.b_!a.?.p,.??.'2~._th_e._w_~½2j~l_~£[ S_a_m_ _u c_LB2 u ]cY_a-Ld_ ] t-h-c- c-x-i s t i-"-g-r-a-m-P-~ F~ ....
nonCompliant. The city is elmible for a Community Development Block Grant.
19. [] This project involves Public Funds, or is a State Lease 20. State Lease NO.
[] This proiect is Privately Funded, on Private Land, f~r Private Use ( fapp cab e)
2'1.1 hereby notify the Texas Department et Licensing and Regulation of the described project and et my intent to perform, or cause to be
performed, all services necessary to design said prOject in accordance with the provisions cf Texas Government Code. Chapter 469. I
certify that I am the registered design prOfesslonal with overall responsibility for the design of the project and whose seal is affixed to the
cor~struction documents
Signature of Design Professional Date *Emai] Address
OR
[ hereby notify the Texas Department of Licensing and Regulation of my intent to comply with the provisions of Texas Government Code,
..................... ...................................
Signature of Building Owner or Designated Agent Date "Email Address
Page 1 of 2
TX DEPT LICEHSING
475 2871 P.03/05
COPPE£L
November 7, 2005
Texas Department of Licensing and Registration
P.O. Box 12157
Austin, Texas 78711
Samuel Boulevard Curb Ramps
SW 05-01
Project Registration / Variance Application
Dem' Sir or Madam:
The City of Coppell intends to construct the Samuel Boulevard Curb Ramp project. The
project consists of the removal and replacement of 26 curb ramps at seven intersections
and six alleys along a section of Samuel Boulevard. We are requesting are requesting a
variance on one of the standards prior to starting the preliminary design of the project.
The following submittals are enclosed:
1. Project Registration Form with registration fee of $175,00;
Variance Application with application fee of $175.00; and
3. Schematic Plans.
Your consideration of this matter is appreciated, and should you have any questions or
need any additional information please advise
Sincerely,
aylor
CIP C~rrdinator
Engineenng Department
Ielephone: 972-304-7019
Fax: 972-304-3570
E-mail: stavlor(~ci.coppell.tx.us
Enclosures
N0~-15-200_~ L19:34 TX DEPT LICENSING 4?5 2871 P.04×05
TEXAS DEPARTMENT OF LICENSING AND REGULATION
Code Review and Inspections Division
ARCHITECTURAL BARRIERS
P,O. Box 12157 o Austin, Texas 78711 * (512)463-3211- (877)278-0999 · FAX (512)475-2886
wv~.lieense..~tat~tx_us · Archit¢cturaI.Barriers(a3~lli_cens¢.$tate,tx.us
POST CONSTRUCTION VARIANCE APPLICATION
In accordance with Rule 68.31, I hereby apply for a post construction variance or waiver of a Standard or specification
required for compliance with the Architectural Barriers Act, Article 9102,Texas Civil Statutes as they apply to the facility
described below on the grounds that literal compliance with the Department's regulations is impractical in this case.
FORM MUST BE C~,MPLETED tN FULL PLEASE PRINT OR TYPE
Project Name ] AB Project Number
Building/Facility Name
Street Address City/Zip Telephone
Owner
Mailing Address City/Zip
Is a state agency located in this building/facility? Yes --_ No
If yes, identify state agency and the state lease number.
Telephone
'$t~t~ agency contact name:
JTelephone
Has bidding or award of contract occurred? ___ Yes __ No
~ Total square footage of building/facility: Per floor:
Check the work pen'ormed: New Construction Addition Renovation/Modification/Alteration
~ --~'hange in Occupancy" ....
IState the section of the Texas Accessibility Standards for which a post construction variance is being requested.
;~ Separate applications must be submitted for each standard or specification to be considered.
i Section # Location and Description of Nonconforming Condition
If the building/facility is a qualified historic buildin9 or facility, identify the historical designation and indicate date of designation
applicable.
tf the building/facility is a qualified historic building or facility, you must provide a determination of effect letter from
the Texas Historical Commission.
State in detail the reason why compliance with the standard or specification is impractical
necessary to achieve cornpliance~
Include the coat
TDLR FORM a034AB 09-04-01 OVER
2005 D9:~4 TX DEF'T LtCENSING 4?5 ~87~ P,05/05
Was a building permit required for this work? ____ Yes ~ No Date Issued;
State the actual cost of construction relating to this project
Have any other building permits been issued for this building/facility within the past 24 months? Yes ___ No
If yes, state the date that permits were issued and the cost of construction for each permit:
Has a certificate of occupancy been issued for the building/facility? _ Yes ____ NO Date Issued____
What is the original date of construction ot this building/facility?
To the best of your knowledge, has a complaint ever been filed on this building/facility relative to accessibility?
:__._~ Yes NO If yes, what were the circumstances? ~- ........ ,.
Was the complaint resolved? __
Exp anat on:__
Yes .... No
Has an inspection been performed by TDLR or a Contract Provider?
Date of Inspection:
Name of Inspector:
Yes_uNo
iPLEASE NOTE; The Department shall decide your application based on information submitted. You should there-
fore include all relevant information with your application, Drawings and photographs may be extremely beneficial.
Date
Company/Firm
Address
City State Zip Code
F-"-I Owner
~]Agent
Signature Telephone
lA $175 00 ~ PAYMENT MUST ACCOMPANY EACH APPLICATION,MAKE CHECK PAYABLE TO THE TEXA~
DEPARTMENT OF LICENSING AND REGULATION AND MAIL TO TDLR P. O. BOX 12157, AUSTIN TEXAS 78711. ~
APPLI,CATIONS RECE VED W THOUT PAYMENT W LL NOT BE PROCESSED. INCOMPLETE APPLIC, ATIONS WILl. ~E RETURNED,~
TDLR FORUM a034AB 09-04.01
TOTAL P.05