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VA Accessiblity Compliance Form (ADA) - Town Of Herndon 2016
Get VA Accessiblity Compliance Form (ADA) - Town Of Herndon 2016-2024
ADA Certification Town of Herndon Building Inspections 777 Lynn Street 2nd Floor Herndon VA 20170 Telephone 703 435-6850 Fax 703 318-8492 E-Mail buildinginspections herndon-va.gov Project Name Project Address Building Permit Number This is to certify that the cost of providing an accessible path of travel exceeds 20 of the cost of the alteration to the primary function area. This is also to certify that the overall cost of alteration to the primary function areas during the preceding three year period has been considered in determining whether the cost of making the path of travel accessible is disproportionate. Only alterations undertaken after January 26 1992 shall be considered in determining the overall cost during the preceding three year period. For the purpose of this certification the term path of travel also includes the restrooms telephones and drinking fountains serving the altered area* Cost of the alteration to the primary function areas Cost of providing an accessible path of travel Disproportionality limit 20 of the alteration cost This is to further certify that the cost of the following work List alterations for path of travel accessibility Is equal to 20 of the cost of the alteration to the primary function The undersigned Print name and title Print street address city state and zip code As owner/tenant of the above mentioned project do hereby certify and agree to the content of this certificate. Signature of Owner/Tenant Signed and acknowledged by On the day of year in the presence of the undersigned witness Witness. Only alterations undertaken after January 26 1992 shall be considered in determining the overall cost during the preceding three year period. For the purpose of this certification the term path of travel also includes the restrooms telephones and drinking fountains serving the altered area* Cost of the alteration to the primary function areas Cost of providing an accessible path of travel Disproportionality limit 20 of the alteration cost This is to further certify that the cost of the following work List alterations for path of travel accessibility Is equal to 20 of the cost of the alteration to the primary function The undersigned Print name and title Print street address city state and zip code As owner/tenant of the above mentioned project do hereby certify and agree to the content of this certificate. For the purpose of this certification the term path of travel also includes the restrooms telephones and drinking fountains serving the altered area* Cost of the alteration to the primary function areas Cost of providing an accessible path of travel Disproportionality limit 20 of the alteration cost This is to further certify that the cost of the following work List alterations for path of travel accessibility Is equal to 20 of the cost of the alteration to the primary function The undersigned Print name and title Print street address city state and zip code As owner/tenant of the above mentioned project do hereby certify and agree to the content of this certificate. Signature of Owner/Tenant Signed and acknowledged by On the day of year in the presence of the undersigned witness Witness.
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