Tdlr Form Ab042 – Fill Out and Use This PDF

TEXAS DEPARTMENT OF LICENSING AND REGULATION

P.O. Box 12157  Austin, Texas 78711

(512) 463-6599  (800) 803-9202  FAX (512) 475-2871

customer.service@license.state.tx.us  www.license.state.tx.us

PROOF OF SUBM ISSION

Per the Texas Architectural Barriers Act, Texas Government Code, Chapter 469, Section 469.101 “All plans and specifications for the construction of or for the substantial renovation or modification of a building or facility must be submitted to the department for review and approval if: (1) the building or facility is subject to this chapter; and (2) the estimated construction cost is at least $50,000.” In accordance with 16 Texas Administrative Code Texas Administrative Rules Chapter 68.50(a), “an architect, interior designer, landscape architect, or engineer with overall responsibility for the design of a building or facility subject to §469.101 of the Act, shall mail, ship, or hand-deliver the construction documents along with a Proof of Submission form to the department, a registered accessibility specialist, or a contract provider not later than the twentieth day after the plans and specifications are issued. In computing time under this subsection, a Saturday, Sunday, or legal holiday is not included.”

The date that plans and specifications are issued shall be as defined in the following provisions of 16 Texas Administrative Code Texas Administrative Rule 68.10(12):

Issue - To mail, deliver, transmit, or otherwise release plans or specifications to an owner, lessee, contractor, subcontractor, or any other person acting for an owner or lessee for the purpose of construction, applying for a building permit, or obtaining regulatory approval after such plans have been sealed by an architect, interior designer, landscape architect, or engineer. In the case of a state-funded or other public works project, it is the time at which plans or specifications are publicly posted for bids, after such plans or specifications have been sealed by an architect, interior designer, landscape architect, or engineer.

DESIGN PROFESSIONAL INFORM ATION								PLEASE PRINT OR TYPE
1.	Last Name:				First Name:			Middle
2.	 Architect	 Landscape Architect		 Interior Designer	 Engineer		3. License #:
4.	Address:							Suite #:
City:						State:		Zip:
5.	Phone:			6. Fax:		7. **Email:
PROJECT INFORM ATION
8.	Project Name:						9. EABPRJ# (if applicable)
10. Project Address:								Suite #:
City:					County:			Zip:

1 1 . I hereby notify the Texas Department of Licensing and Regulation of the described project and of my intent to perform, or cause to be performed, all services necessary to design said project in accordance with the provisions of Texas Government Code, Chapter 469. I certify that I am the registered design professional with overall responsibility for the design of the project and whose seal is affixed to the construction documents. I am mailing, delivering, transmitting, or otherwise releasing these construction documents to an owner, lessee, contractor, subcontractor or other person for the purpose of construction, applying for a building permit, or obtaining regulatory approval. In the case of a state-funded or other public works project, it is the time at which construction documents are publicly posted for bids.

__________/__________/_______________

Date Construction Documents Issued
__________/__________/_______________	to  TDLR
Date Construction Documents Submitted	 RAS #_____________ Name: ____________________________________________________
Signature of Design Professional:	Date of Signature:	/	/
TDLR USE ONLY	DO NOT W RITE BELOW THIS LINE

TDLR FORM AB042 08-12 NOTE: An individual who completes and files 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)to have the Department correct information about the individual that is incorrect, under Section 559.004 of the Texas Govt. Code.

**The Department will add your address to the Architectural Barriers email notification list, which automatically provides Department information on matters affecting Architectural Barriers. Your email address is confidential pursuant to the Texas Public Information Act; the Department will not share it with the public. For additional information link to: http://www.license.state.tx.us/newsletters/TDLRnotificationLists.asp