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HomeMy WebLinkAboutHLP2020-3699 GRAPEVINE, T R K A S OCTOBER 9, 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 October 13, 2020 at 7:30 a.m., with a rain date of October 23, 2020 at 7:30 a.m. Melanie Hill, Risk Manager /t Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410-3158 Permit will not be issued until FAA Approval has been received. 0:\CCOOK1InstructionslHelicopterinto\CoverLetter MEMORANDUM CITY OF GRAPEVINE TEXAS TO: BRUNO RUMBELOW, CITY MANAGER MELANIE HILL, RISK MANAGER FROM: DON DIXSON, BUILDING OFFICIAL SUBJECT: HELICOPTER LIFT REQUEST DATE: OCTOBER 9, 2020 Attached is a request for a helicopter lift scheduled for October 13, 2020 at 7:30 a.m. for 3000 Grapevine Mills Pkwy #515 with a rain date of October 23, 2020 at 7:30 a.m. if it meets your approval, please sign below: �s -- - City Manager ------- ` �— Risk Manager Development Services Assistant Director FAA Approval 09CCOOKUnstructions\Hei,coplerini0\MEMO -/. - HELICOPTER LIFT PERMIT ,�j�,�})�i Issue Date:October 12,2020 •i PROJECT DESCRIPTION:Helicopter Lift-October 13,2020 with Rain date of October 23,2020 @ 7:30 a.m. -- "Marc Samuel's Jewelers" �� PROJECT# (817)410-3010 www.mygov.us -'� HLP-20-3699 Inspections Permits City of Grapevine P.O.Box 95104 LOCATION TENANT LEGAL Grapevine,TX 76099 3000 Grapevine Mills Pkwy. Marc Samuels Jewelers Grapevine Mills Addition Blk 1 (817)410-3165 Voice Suite#515 Lot 1r3 (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 2020-10-13 07:30 am RAIN DATE FOR HELICOPTER LIFT 2020-10-23 07:30 am Zoning CC-Community Commercial MYGOVLS City of Grapevine I HELICOPTER LIFT PERMIT I HLP-20-3699I Printed 10/12120 at 3:24 p.m. Page 1 of 1 +) ` MECHANICAL PERMIT (VALUE) Issue Date:September 1,2020 7 f l ♦ ' PROJECT DESCRIPTION: Replace RTU"Marc Samuels Jewelers" t PROJECT# (817) 410-3010 www.mygov.us MECH-20-3120 Inspections Permits City of Grapevine LOCATION TENANT LEGAL P.O.eon ,TX 3000 Grapevine Mills Pkwy. Marc Samuels Jewelers 1 grapevine Mills Addition Elk Grapevine,TX 76099 9 p Suite#515 1 Lot 1r3 (817)410-3165 Voice Grapevine, TX 76051 (817)410-3012 Fax CONTRACTOR INFORMATION Noble One Contractors[MECH] 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[MECH](Nizar Yousuo Indianapolis, IN 46204-6120 Cc on 09/01/2020 ($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 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall.-Marc Samuel Jewelers#515 3000 Grapevine Mills Pkwy Grapevine,TX 76051 NATURE OF OPERATION: Helicopter external lift operation of Roof Top Units to building roof. DATE OF OPERATION: 13 October 2020 with rain date of 23 October 2020 with a 10 day grace period for each date mentioned. I, Shawn Harris,the undersigned, representing S-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 and judgments, 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. 1,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 8 day of October 2020 COMPANY:5-STATE HELICOPTERS, INC. BY:Shawn Harris(printed) Shawn rriS TITLE:OWNER (signature) STATE OF Texas COUNTY OF Rockwall This instrument was acknowledged before me on this the day of�2020 NOTARY PUBLIC IN AND FOR THESTATE OF . My commissi xpires 1S r -26;w \��aY�p��� SUSAN BITROS Sin ture ?o`F' a g _:: �-Notary Public,State of Texas �y.�.�.� Comm.Expires 08-26.2024 %.'q�'�o;�'�;.`' Notary, Ib 132843898 17" M�Griff Certificate of Insurance Certificate No. 106976 Rev.Date:Oct 08,2020 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 binders)stated herein.This certificate cancels and supersedes all previously issued certificates. Certificate Holder: City of Grapevine 200 S. Main Street 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 12:01am Local Standard Time at the address ofthe Named Insured shown above Insurer(s): Company Policy No(s). Endurance American Insurance Company through W. Brown and. NAC6030702/NAF6030703 Associates 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 Property Damage Liability and 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. Auth r zcdRcpr ntativc 7525 SE 24th Street,Suite 520,Mercer Island,Washington 98040 Phone:(206)232-9870-Fax: (206)232-9515 n TATE 51' HELICOPTEAS AIRCRAXFSFAYEEC Date: October 9, 2020 To: FAA Office North Texas FSDO REFERENCE CONGESTED /CONTINGENCY—SAFETY PLAN DATE/TIME OF JOB JOBSITE INFORMATION CONTRACTOR INFORMATION DATE: October 13,2020 ADDRESS: Grapevine Mills Mall / Noble One Contractors Marc Samuels Jewelers#515 TIME FRAME:8:00AM-10:00An 3000 Grapevine Mills Pkwy 11311 A Hines Blvd Grapevine, TX 76051 Dallas,TX 75229 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 TRANSPORT CATEGORY INFORMATION: N4XY SIKORSKYS-58T TRANSPORT CATEGORY N170MC KAWASAKIBK-117 TRANSPORTCATEGORY PILOT INFORMATION: Bradford Ladue COMMERCIAL CERTIFICATE #2760587 Robert Smith COMMERCIAL CERTIFICATE#3493515 Andrew Smith COMMERCIAL CERTIFICATE#3893823 PREPARED BY: Susan Bitros Zx4 d� APPROVED Digitally signed byTHOMAS R NTX FSDO SW19 GOOD APPROVED BY: Date:2020.10.09 12:27:19-05'00' OPERATING CERTIFICATE #LDUL599B 285 BLACKLAND ROAD FATE,TEXAS 75189 (972) 636-4009 51' HELICOPTEAS uscwssassvcss LOAD DESCRIPTION HAZMAT(DOT-SP 16606, DOT-SP 20490):YES NO X X ROOFTOP UNITS MATERIALS EQUIPMENT OTHER: NUMBER OF TOTAL LIFTS (RANGE): 1 - 5 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) RS, BUILDING OCCUPIED DURING LIFT: YES NO X * IF YES, ESTIMATED LOAD PENETRATION OF FLOORS None AREA CONSIDERED CONGESTED: YES X NO OPERATING CERTIFICATE #LDUL5996 285 BLACKLAND ROAD FATE, TEXAS 75189 (972) 636-4009 STATE HELICOPTERS WRCRANESEIMCM CONGESTED COMMERCIAL AREA CONGESTED RESIDENTIAL AREA --XL-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 (972) 636-4009 54`1 HELICOPTEAS AIACAANESEANCES Notification of Grapevine City Officials 5 State Helicopters has contacted the following city officials about the lift to be performed on October 13, 2020: 3000 Grapevine Mills Pkwy, Grapevine, TX 76051 City Manager: Connie Cook 817-410-3155 Your message has been delivered to the following recipients: Connie Cook (ccook@grapevinetexas.gov) Subject: 5 State Helicopter Lift of HVAC Equipment October 13, 2020 in Grapevine at approximately 8:OOAM - 10:OOAM Police: Mike Hamlin 817-410-3225 Your message has been delivered to the following recipients: 'mhamlin@grapevinetexas goy' (mhamlin(cbgrapevinetexas qov) Subject: 5 State Helicopter Lift of HVAC Equipment October 13, 2020 in Grapevine at approximately 8:OOAM - 10:00AM Fire Chief: Darrell Brown 817-410-4400 Your message has been delivered to the following recipients: dbrown@grapevinetexas.gov (dbrown(olgrapeyinetexas goy) Subject: 5 State Helicopter Lift of HVAC Equipment October 13, 2020 in Grapevine at approximately 8:OOAM - 10:OOAM ATC: Dallas Fort Worth International Airport 972-615-2605 Your message has been delivered to the following recipients: Segleski Matthew Y (FAA) (matthew v segleski(cbfaa qov) Subject: 5 State Helicopters lift operations 4 miles North of DFW on October 13, 2020 Sincerely, csda� gldL 5 State Helicopters OPERATING CERTIFICATE #LDUL599B 285 BLACKLAND ROAD FATE, TEXAS 75189 (972) 636-4009 Grapevine Mills Mall s ♦ e- = - - - - 3000 Grapevine Mills Pkwy F` • ♦ F _: '' h. P• - �7 Grapevine.. TX 76051 r F ♦ - � P F-M r ,� •` 1!s ! -�J .. N Date of Lift: 10/13/2020 ' ® �,. • rB • •. T �. Time ` q. P� r + •� ¢ 8.00AM I �.'.� .• P _t k � 320 58' 00.8"N • '.` a*P. • St ,L. E�a�tPa,n • — l? �• - R as�n� �a LandnB Area - 1. r '- n - s<ael�area Blovketl Freas x r ^ P : I• a F e�9e0c ' •P r r ' P • /� " r / ygre �jy t Py, •• p � r �• P P r P Grapevine Mills Mail N°G 1 "A asi ,,? /(Pm) t' 3000 Grapevine Mills Pkwy cP.0 'OH LflYLSWLLE_ t�H BA LOft SCOTTS WHITE n / CARROLLTON ,F!//`` SH40H S>2 L OI Grapevine, TX 76051 BLncN RK N gd qJ Date of Lift: �DN ®OBJECTIONABLE � , I �� 10/13/2020 1s�� \ 110 ., Time: —.1__ L�� �! tJ 25 8:o0AM , 32'58' 00.8"N Fo H au r' F 97'02' 25.0"W e NA'L (Ben' uftRaLroN � ViM116'[IIORYTYi61M,x T1E FMMMgt6lC _ __ �N«++++ 0 COURSF�TOPVNWATStJl�1]G_1]r1.1BLANDI� �— GTF3� ee'oW hAw ��� r l/ 7suti •WM -\. 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