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Home My WebLink AboutHLP2020-3031 MEMORANDUM CITY OF GRAPEVINE. TEXAS. TO: BRUNO RUMBELOW, CITY MANAGER MELANIE HILL, RISK MANAGER FROM: SCOTT WILLIAMS, DEVELOPMENT SERVICES DIRECTOR/ BUILDING OFFICIAL SUBJECT: HELICOPTER LIFT REQUEST DATE: AUGUST 25, 2020 Attached is a request for a helicopter lift scheduled for September 2, 2020 at 7:30 a.m. for 3000 Grapevine Mills Pkwy #515 & 3000 Grapevine Mills Pkwy #301, with a rain date of September 14, 2020 at 7:30 a.m. if it meets your approval, please sign below:. City Manager Risk Manager �� De opment Services Director V FAA Approval O:%CCOOKIInstrucbons%HelicopteriniolMEMO T l:•. X I S August 25, 2020 The attached application is for a Helicopter Lift Request. Please sign the attached memo and forward packet to the City Manager's Office. Once City Manager has signed please return to Connie Cook, Development Services. Location: 3000 Grapevine Mills Pkwy #515 — Marc Samuel's Jewelers & 3000 Grapevine Mills Pkwy #301 — Treasure Custom J 9-r—s. September 2, 2020 at 7:30 a.m., with a rain date of September 1 , 2 at 7:30 a.m. Melanie Hill, Risk Manager Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410-3158 Permit will n issued until FAA A val has been received. 0:1CC00 K1lnstructi ons\Hel icopterinfolCoverLetter -07NI ., HELICOPTER LIFT PERMIT Q ` NE Issue Date:September 1,2020 r l: t ; PROJECT DESCRIPTION:Helicopter Lift-September 2,2020 with Rain date of September 6,2020 @ 7:30 a.m."Marc Samuel's Jewelers" PROJECT# City of Grapevine P.O.Box 95104 LOCATION TENANT LEGAL Grapevine,TX 76099 3000 Grapevine Mills Pk p wy. Marc Samuels Jewelers Grapevine Mills Addition Blk 1 (817)410-3165 Voice Suite#515 Lot 1 r3 (817)410-3012 Fax Grapevine,TX 76051 CONTRACTOR INFORMATION 5 State Helicopter's —APPLICANT NAME Susan Bitros 285 Blackland Rd. —APPLICANT PHONE NUMBER 9726364009 Fate,TX 75189 APPROVAL CITY MANAGER YES (972)636-4009 Phone APPROVAL DEVELOPMENT SERVICES YES APPROVAL RISK MANAGEMENT YES OWNER County Tarrant Grapevine Mills Mall Lp DATE&TIME OF HELICOPTER LIFT 2020-09-02 07:30 am RAIN DATE FOR HELICOPTER LIFT 2020-09-06 07:30 am J Zoning CC-Community Commercial 1 MYGOV.US City of Grapevine I HELICOPTER LIFT PERMIT I HLP-20-3031 I Printed 09/01/20 at 1:51 p.m. Page 1 of 1 MECHANICAL PERMIT (VALUE) ju AP-E1 K Issue Date:September 1,2020 t f t ; PROJECT DESCRIPTION:Replace RTU"Marc Samuels Jeweler's" •k PROJECT# (817)410-3010 MECH-20-3120 Inspections City of Grapevine LOCATION TENANT LEGAL P.O.Box 3000 Grapevine Mills Pkwy. Marc Samuels Jewelers Grapevine Mills Addition Blk 1 TX Grapevine,,TX 76099 Suite#515 Lot 1 r3 (817)410-3165 Voice Grapevine,TX 76051 (817)410-3012 Fax CONTRACTOR INFORMATION Noble One Contractors Is Duct Work Being Installed? NO State ID#TACLA102223C Square Footage 3400 11311 HARRY HINES BLVD 515 VALUATION 11600 Dallas,TX 75229 (903)744-3353 Phone FEES TOTAL=$131.40 Mechanical Permit Fee{Value} $ 131.40 OWNER PAYMENTS TOTAL=$131.40 Grapevine Mills Mall Lp 225 W Washington St Noble One Contractors(Nizar Yousuo Indianapolis, IN 46204-6120 Cc on 0910112020 ($131.40) ph.(317)636-1600 NOTICES ALL work must be done in compliance with the 2006 INTERNATIONAL AVAILABLE INSPECTIONS MECHANICAL CODE. Mechanical Final(required) PLAN SUBMITTAL:WHEN PLANS ARE REQUIRED BY CODES, ORDINANCES,OR AS DETERMINED BY THE BUILDING OFFICIAL,THREE (3)SETS OF PLANS SHALL BE SUBMITTED IN HARD COPY FORMAT. ENGINEER SEALED PLANS AND CALCULATIONS SHALL BE SUBMITTED AS REQUIRED BY CODES,ORDINANCES OR WHERE OTHERWISE REQUIRED BY STATE LAW. READ AND SIGN I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF MY KNOWLEDGE AND ALL WORK WILL BE PERFORMED ACCORDING TO THE DOCUMENTS APPROVED BY THE BUILDING DEPARTMENT AND IN COMPLIANCE WITH THE CITY OF GRAPEVINE CODES REGULATING CONSTRUCTION.IT IS UNDERSTOOD THAT THE ISSUANCE OF THIS PERMIT DOES NOT GRANT OR AUTHORIZE ANY VIOLATION OF ANY CODE OR ORDINANCE OF THE CITY OF GRAPEVINE. I FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH ANY FEDERAL,STATE,AND/OR LOCAL LAW REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS,AND THAT VERIFICATION OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST. Signature Date MYGOV.US City of Grapevine I MECHANICAL PERMIT{VALUE}I MECH-20-3120 I Printed 09/01/20 at 1:33 p.m. Page 1 of 3 -K 8 W i McGriff, Seibels &Williams, Inc. Certificate of Insurance Certificate No. 106976 Rev.Date:Aug 25,2020 This is to certify that the policy(ies)of insurance as described below have been issued to the Insured for whom this Certificate is executed and is/are in force at this time.This Certificate is issued for information only and confers no rights upon the holder.This Certificate neither affirmatively nor negatively amends,extends or alters the coverage afforded by such policy(ies)or binder(s)stated herein.This certificate cancels and supersedes all previously issued certificates. Certificate Holder: City of Grapevine PO Box 95104 Grapevine,TX 76051 Named Insured: 5 State Helicopters,Inc. 285 Blackland Road Fate,TX 75189-4746 Policy Type: Aircraft Hull&Liability and Aviation General Liability Policy Policy Period: February 15,2020 to February 15,2021 both days at 12:01 am Local Standard Time at the address of the Named Insured shown above Insurer(s): Company Policy No(s). Endurance American Insurance Company through W.Brown and Associates NAC6030702/NAF6030703 Aircraft Covered: Sikorsky S58ET,N6BL;Sikorsky S58ET,N4XY;MBB/Kawasaki BK-117,N170MC Coverage&Limits Aircraft Liability Coverage Limit Combined Single Limit Bodily Injury,including Personal Injury and $5,000,000 each occurrence as respects MBB/Kawasaki BK-117 and Property Damage Liability Sikorsky S-58ET type aircraft. Cargo Legal Liability Coverage Limit Cargo Legal Liability including Slung Loads $500,000 each occurrence,subject to a deductible of$2,500 each claim. AuthP=dRepxWhtative 7525 SE 24th Street,Suite 520,Mercer Island,Washington 98040 Certificate No: Page 1 of 1 Phone:(206)232-9870-Fax:(206)232-9515 106976 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS:Grapevine Mills Mall-Marc Samuel Jewelers#515&Treasure Custom Jewelers#301 3000 Grapevine Mills Pkwy Grapevine,TX 76051 NATURE OF OPERATION: Helicopter external lift operation of Roof Top Units to building roof. DATE OF OPERATION: 26A gtr�t 2020 with rain date of QdSeptember 2020 with a 10 day grace period for each date mentioned. I, Z4 ir, & C rl&kt; ,the undersigned,representing 5-State Helicopters,Inc., binding my heirs, executors,administrators,estate and assigns,do hereby agree to completely and wholly release indemnify the hold harmless the city of Grapevine, its officers,agents, independent contractors,and employees from any and all claims, damages,personal injury,including death, property damage, lawsuits andjudgments, including court costs,expenses and reasonable attorney's fees,and all other expenses resulting from any and all activities conducted within the city of Grapevine,Texas. It is the understanding of all parties that this release, indemnity,and hold harmless agreement shall apply whether or not the claims,damages,harm, personal injury, including deaths, property damage, lawsuits, judgments,court costs,attorney's fees and any other expenses arise from the negligence of whatever nature,omissions,willful and intentional acts of this individual, company or company's officers, agents, employees,independent contractors,other representatives, invitee,licensee,or guests. I,the undersigned individual and/or company company's officer,certifies,warrants and represents that the individual whose signature appears below is duly authorized to execute this agreement on behalf of the firms,corporation,partnership or other entity who will operate within the city of Grapevine,Texas. In witness whereof,this agreement has been executed this u-1+r7 day of_ uJ 2020 COMPANY:5-STATE HELICOPTERS,INC. BY: (printed),Jnhn �/tt:r/�� I TITLE:,+;,&hznP (signature) STATE OF X COUNI Y OF This instrument was acknowledged before me on this the 20o-day of 100 G'.. 2020 NOTARY PUBLIC IN AND FOR THE STATE OF—QQ<fJ S �yRY MCMIA�+ My commi n x Tres c s Signature. _ _ S i •.� 4.�f' : ..� f '00 5 FHE.uc Date: August 21, 2020 To: FAA Office North Texas FSDO REFERENCE: CONGESTED /CONTINGENCY—SAFETY PLAN DATE/TIME OF JOB JOBSITE INFORMATION CONTRACTOR INFORMATION DATE: -A_mg t-2&iA20 ADDRESS: Grapevine Mills Mall/Marc Noble One Contractors �Q*it,A020 Samuels Jewelers TIME FRAME:07:30-09:00 3000 Grapevine Mills Pkwy 11311 A Hines Blvd Grapevine,TX 76051 Dallas,TX 75229 n DAr JOBSITE CONTACT:Nick Yousus CONTACT:Nick Yousus PHONE NUMBER:903-744-3353 PHONE NUMBER:903-744-3353 **SHOULD A WEATHER,MECHANICAL OR MATERIAL DELAY BE EXPERIENCED,THIS PLAN IS APPROVED FOR ABOVE LISTED DATE PLUS 14 CALENDAR DAYS.** AIRCRAFT N6BL SIKORSKY S-58T r TRANSPORT CATEGORY INFORMATION: N4XY SIKORSKY S-58T I TRANSPORT CATEGORY + F i PILOT INFORMATION: Bradford Ladue COMMERCIAL CERTIFICATE #2760587 Robert Smith COMMERCIAL CERTIFICATE#3493515 Andrew Smith COMMERCIAL CERTIFICATE#3893823 PREPARED BY: John Hencinski `y�i� Digitally signed APPROVED BY: APPROVED by lnlynn Davila NI FSDO sW 01 Date:2020.08.24 10:52:58-05'00' OPERATING CERTIFICATE#LDUL599B 1 285 BLACKLAND ROAD FATE,TEXAS 75189 (972)636-4009 285 BLACKLAND ROAD FATE,TEXAS 75189 5 (972)636-4009 FHEUCO.PTERS August 21,2020 Connie Cook, City of Grapevine Attention: City Manager Reference: 5 State Helicopters Landing and Operations This letter,with the location,dates, and time of a helicopter external load operation that is being flown by 5 State Helicopters,Inc. is to ensure there are no restrictions or regulations preventing the helicopter from landing within the city limits of Grapevine, Texas. Date/Time of Job: Location: Contractor: Grapevine Mills Mall/Marc Noble One Contractors �p►1� a j ScpOr a I PXO Samuels Jewelers 07:30 - 09:00 3000 Grapevine Mills Pkwy 11311 A Hines Blvd Grapevine, TX 76051 1 Dallas,TX 75229 Helicopter Type: Sikorsky S58T,Kawasaki BK 117, Sikorsky UH-60 TRANSPORT CATEGORY Call Sign: N4XY (Blue), N6BL (Red), N170MC (Yellow)-N112HC (Green) Pilots: Bradford Ladue, Robert Smith,Andrew Smith, Steven Phelps 5 State Helicopters, Inc. assures the City of Grapevine, Texas that it will comply with all State, Federal and local regulations,holds and required permits and is licensed to do the type of work as described in this request. 5 State Helicopters, Inc. agrees to provide a Certificate of Insurance with liability coverage of$5,000,000.00 showing the City of Grapevine as an additional insured. Please feel free to contact 5 State Helicopters with any questions and/or concerns that you may have. Office: 972-636-4009 Please sign and e-mail back to: SINCERELY, APPROVED/DISAPPROVED BY DATE 1 5ATE HELICOPTERS Notification of Grapevine City Officials 5 State Helicopters has contacted the following city officials about the lift to be performed on August 26, 2020: 3000 Grapevine Mills Pkwy, Grapevine, TX 76051 City Manager: Connie Cook 817-410-3155 Your message has been delivered to the following recipients: Subject: 5 State Helicopter Lift of HVAC Equipment August 26, 2020 in Grapevine at approximately 07:30 - 09:00 Police: Mike Hamlin 817-410-3225 Your message has been delivered to the following recipients: ' Subject: 5 State Helicopter Lift of HVAC Equipment August 26, 2020 in Grapevine, TX at approximately 07:30 - 09:00 Fire Chief: Darrell Brown 817-410-4400 Your message has been delivered t, ollowing recipients: Subject: 5 State Helicopter Lift of HVAC Equipment August 26, 2020 in Grapevine, TX at approximately 07:30 - 09:00 ATC: Dallas Fort Worth International Airport 972-615-2605 Your message has been delivered to the following recipients: Subject: 5 State Helicopters lift operations 4 miles North of DFW on August 26, 2020 Sincerely, 5 State Helicopters Digitally OPERATING CERTIFICATE#LDUL599B signed by 285 BLACKLAND ROAD Jolynn FATE,TEXAS 75189 DOSWI� Davila Date: (972) 636-4009 2020.08.24 10:54:58 -05'00' 5wS'TRTE 4N!!!CRPT�RS LOAD DESCRIPTION HAZMAT(DOT-SP 16606, DOT-SP 20490):YES NO X X ROOFTOP UNITS MATERIALS EQUIPMENT OTHER: NUMBER OF TOTAL LIFTS (RANGE): 5 - 10 WEIGHT RANGE: 500 Ibs-1 600 Ibs PERCENT MAX LOAD: 38% LOAD AERODYNAMIC: YES NO X LENGTH OF ATTACHING GEAR(FROM HOOK TO BOTTOM OF LOAD) 85' BUILDING OCCUPIED DURING LIFT: YES NO X * IF YES, ESTIMATED LOAD PENETRATION OF FLOORS None AREA CONSIDERED CONGESTED: YES X NO OPERATING CERTIFICATE#LDUL59913 Digitally signed by 285 BLACKLAND ROAD Jolynn Davila FATE TEXAS 75189 APPROVED xrXFSDOSDoswil Date: (972)636-4009 2020.08.24 10:53:36 -05'00' HELICOPTERS *J t__5 iwarri Smw CONGESTED COMMERCIAL AREA CONGESTED RESIDENTIAL AREA X CONGESTED AREA PROBABILITY/POSSIBILITY This is a congested area operation. Items are located in staging area(s) on either transportable vehicles or ground surface. Item(s)to be placed on building/structure roof top(s) or designated areas. Direct flight path(s) from staging area(s)to placement area(s) will occur unless otherwise notated on provided maps. Lift(s) amount(s), description(s), order and placement could be altered by contractor personnel however, pick up site and drop site shall not be outside the parameter of this request. Helicopter landing area(s) will be secured at all times (prior, during and departure). Flight path(s) during lift operations inside the designated operational area(s) will remain clear of unauthorized personnel, equipment, obstacles at all times. Flight path(s) will remain within operational area(s) at all times. The operational area(s) has been surveyed for hazard(s) and mitigated to the lowest risk level acceptable to, or able to obtain, by both 5 State Helicopters, Inc. and contractor(s). Should an unforeseen, or additional hazard(s) surface, lifting will immediately halt till the hazard(s) have been rectified or mitigated. Primary means of communication via radio will be maintained constantly during the operation. Secondary means of communication via hand signals will be immediately incorporated should radio communications fail. Appropriate ATC communications will be maintained by pilot in all possible and/or feasible situations. Narrative: Due to the job-site being an existing mall we classify this to be a potential congested area. All entrances will be blocked and controlled by security personnel so that no unauthorized persons shall enter or cross the operational area. The Mall inside the operational will remain vacant during operations. OPERATING CERTIFICATE#LDUL599B 285 BLACKLAND ROAD FATE,TEXAS 75189 Digitally signed APPROVED byJolynn Davila (972) 636-4009 N7 MOSWI9 Date:2020.08.24 7 0:53:56-05'00' Grapevine Mills Mall * 3000 Grapevine Mills Pkwy r ► ' = • * ~ e t. Grapevine,TX 76051 r r * j t V ,F ;�• ,� l/ Date of Lift: +� 0872641H0 ' r F ` � • t+ Time: r 320 58' 00.8"N w r as R F 970 02' 25.0"W t. t Operational Area a p' t r t,q/ Flight Path • �' • a O I Landing Area 4 w Staging area ' r• - :.'■ /` 'I r • t R F any�andin I Emergenq Area .rr Blocked Areas w ~ rg�ne r a R .y .. 4.: Ygrea r + a f - F fe w a 1 51 . �, �•* '■ • APPROVED ._ a NTSFSDDSWI, r r F b ► It �fk w Grapevine Mills Mall Z' ` • j v` ers:• '' , Ttp.-I Grapevine Mills Pk �a, !M") SATiORSLITAWWTE 3000 Gra p wy 4 1 x CA>:aaq►IM Grapevine,TX 76051 "OH SA ,' 4AW Date of Lift: H �OKM � '4 r', N 7e OS/�`81 0 r� 110 Q-9+-" Time: I lylia 2 07:30 32'58'00.8"N Xw H ,o;o — - 9rr7 ,—f 97 02'25.0"W ` e�e7t eAruwuxON - .JRI.!>m TO Rl1 TFgD{/0117r�RW1 -GSF} L!Y TSS FUNNeAY$ 71,�,17„1867 rrL 15t.ArWiMf. ,,,r f..r 1 t l3tlFi.A r� G r OPELA ALTRIIOE GErrM:BN$OLANA COMPLEX A W �» NOFTM LUE$69X lA BE AT ORSR4%V 100 MUS r �(i�°• F M3L 4WNFN OFW IS ON FMTM FLOW AND ( '" �EET a�e++ma EOOAIA conFux 'A7 OFt 86L4W D00 FEES A�SL wvNEN DF+W FC M .'`f 014 110 lDIr7M Ow + M 7074k *07% CU ' !r,� -- n..oa scxFTr a waDTe 20 ORAPEVNE f 114, 12i 1 F :. Iwo ry,F 635 E fi6�R :i. a IPP$7 ante 1Y7.S Ply i �' .�olynn Davila AANGEFF �' .t' I cow, vrzsnoswil L r A 14w :=e COLL£IMLEE Irate: '2020.08.24 1 6:17 TOWER 5. 0' T&fA NO SWFR 3Tm _ 3 •FT WORTH N7TL WM cT-1b4.15126,55127.$134.9 .A r 12E,776 r i err?L I2 93 Helicopter will not Y •• ,_ A dr,9 F �' F�74kT Be more than 125' fi URL13'riAla Ftlrl("DV.0111;w WALi>1Fl+i7gLtH tH coukwTaN{m*Aysj3zt „1 F: uwyu Above a 40'building iNo f' 4 E�tss1 + When air lifting j .r w I °� _ A WAWG Equipment to the BEDFORDAt71,ILOEEEi1MffN SOtl Fi=An'f- !$.I a A u �- �RWwcw�L,.aF+DuroeEwroaStllWr,000 Roof. H iF0°�1 1F'W .i FEET MIL WAR!l oFWA IS*VM MAND . :-N GA1u NOR PAST 1 1' AtxHrm loaFs x M$L W r NOS%i% ti! ill Pilot will contactATC: 18 _ i � T a1 .^ Dallas Fort Worth asoa i International Airport r.Y. .D •wrn;vFo��r99• - 111 .- Y. r . ■ �Starbucks Bur!ina Fri k. • � /' r i,;i3f:KC�f tSarrf'�- 1 Y 41d Co�nirprStcre i { AMA 4iN�-kN � ��,�.'• � �1�rrk*� 1 [;ra~`i'r.e M I II S 3n AAarc Samuel w I�rs i { �'• ng 'dia a Fe11 wshlp Church x, ab;�r� f Grape•nr,P-c3^,pus �- hick i[ ` _ ! 7 AHilton Lak '=xecutii'e�•es atabur. er� P } s $ ' bSars'Pra'Sho�, -.Lieu[+n ,.• fz. w ��s�`Lrnbass.y Suites F..i�.`vro u+bYL�iL�tan Gal' aS VFW' I r'1 r �y tar+.1,5•!cif