HomeMy WebLinkAboutCO2020-3592 UNDER CONSTRUCTION
CORRECTION LETTER
PW OR LD NEEDED
TD NO LETTER
WAITING FIRE
HOLD
CODE
C/O CHECK LIST
C/O PERMIT # P20 — 3 5 9 c9—,
ADDRESS: & 00 ��• �S�y
BUSINESS NAME:
BUSINESS/PROPERTY
CHANGE NAME /OWNER NEW CONST/ADDITION PERMIT#
NEW TENANT/OCCUPANT REMODEL/ALTERATION PERMIT#
ISSUE DATE FINAL DATE
v/ 1. APPLICATION FORM COMPLETED
L,�2. ZONING MAP COPIED &WORKORDER FORM COMPLETED
3. HAZARDOUS MATERIAL SAFETY DATA SHEETS TO FIRE DATE
(SCAN TO C/O IN MYGOV—IF LARGE SET,ALSO SCAN TO LF&FORWARD SET TO FIRE)
4. FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATE
//5. ZONING CHECKED &COMPLETED ON APPLICATION
V/6. BUILDING INSPECTION SCHEDULED DATE /- 0/a TIME
y 7. FIRE DEPT. INSPECTION SCHEDULED DATE JO TIME
FIRE INSPECTOR:
8. CITY SECRETARY(ALCOHOL) NOTIFICATION DATE:
9. HEALTH INSPECTION NOTIFICATION DATE:
10. PUBLIC WORKS INSPECTION E-MAIL DATE
11. LOT DRAINAGE INSPECTION E-MAIL DATE
12. CORRECTION LETTER SENT DATE
13. BUILDING INSPECTORS SIGN OFF LETTER: YES / NO
14. FIRE DEPARTMENTS SIGN OFF LETTER: YES / NO
15. HEALTH DEPARTMENT SIGN OFF
16. CITY SECRETARY(Alcohol License Sign Off)
17. PUBLIC WORKS SIGN OFF
18. LOT DRAINAGE SIGN OFF
—v19. LANDSCAPING SIGN OFF
✓ 20. BUILDING OFFICIALS SIGNATURE /
V 21. C/O CERTIFICATE ISSUED ELECTRIC RELEASED: lvlao'lay
SCAN CERTIFICATE TO MYGOV: I 1 r T N�l�
CONDITIONS 1 u tst TYPEL) ON C!O'.' its r Nk. MAILED: _ ��
1.)CT
01FOR MSIOSCOIN FORMATIOMCKLIST
121301041 R-11111,11115,5118
®C.T 5 2020 * DATE OF ISSUANCE:
G
T K x A s PERMIT#: Z) `�S
CERTIFICATE OF OCCUPANCY RE UEST
FEE: $50.00
NO FEERBQUIRED IF CERUFICATE OF OCCUPANCYISASSOCIATED WITHANACTnT CURIfE ►TBUILDINGpER jT
ADDRESS OF OCCUPANCY: N OO W e S* ore SUITE# 4�
LOT: BLOCK: SUBDIVXSION: i r.
** * _
CERTIFICATE OF OCCUPANCY WII,I,NOT BE LSSUED ROUT LEGAL DESCRIPTION****
NAME OF BUSINESS: ro r ro}d •t - ,�
NEW OCCUPANT: YES NO NEW BUILDING/PROPERTY O ER: NO
NEW BUILDING: YES NO NEW BUSINESS NAME CHANGE: YES NO
NUMBER OF EMPLOYEES: FREIGHT FORWARDING: YES NO
SQUARE FOOTAGE:
TYPE OF SUSxNESS:
NEW BUSINESS OWNER: YES NO ,
tc� I
(Example:Retail Clothing/Attoraey's Office/Oltice-WareLowe/Restaurant) -
NAME OF TENANT [PERSON'S NAMEPtA— �.
CURRENT MAILING ADDRESS:
CITY/STATE/ZIP: O PHONE NUMBER: 03 $�J j�t f e x 4-
_ $�
~PROPERTY OWNER: /D r .9H ve' o T to c,5
MAILING ADDRESS: l O We
CITY/STATE/ZIP: �N�C PHONE NUMBER: 2 ( a as
♦ IS YOUR BUSINESS SUBJECT TO SALES TAX LAW?(if yes,provide copy of Sales Tax Certificate).--- YES NO /
• WILL THERE BE ALCOHOLIC BEVERAGE SALES?(if yes,provide copy of Alcoholic Beverage Permit)-YES NO
+ PERMM ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED?-------_----------
WILL• BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM?--___-YES NO
♦ WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY? YES NO
(if yes,screening is required)-............ .......----- ------------------...............
♦ WILL THERE BE ANY OUTSIDE YES NO
USE OR DINIIITG?-.._-_._-__- STORAGE-(including storage of veLicles),DIgpLAY,
•---------------"-------....
"---------- YES
♦ WILL ANY ALTERATIONS __-_
.♦ IS BUILDING SPRINE LERED?MADE TO THE SITE OR BUILDING?--------------- ------... YES NO
♦ WILL BUSINESS STORE OR HANDLE HAZARDOUS MA - - - ------------ YES
- YES�NO
(if yes,provide list of types&quantities,along with material saf sheets)4UID5?-
I HEREBY CERTIFY THAT THE FOREGOING I5 CORRECT TO THE BEST OF MY KNO W WLEDGE AN-_---------D THE SAID NO
YES
OCCUPANCY IS IN CONFORMANCE WITH THE INFORMATION HEREIN SET FORTH.
(If access to the buildingispace is not provided at the time of the scheduled inspection,a$42.00 M-ins ection fee will be charged)
FOR QUESTIONS PLEASE (817)410-3165.
SIGNATURE: PRINT NAME:. j o h ti XVIM5
PHONE#: O o:) EMAIL:
Development Services Department •
(817)410-3165
Fax(817)410 3012*www.eraneviuetexas.gov
0:F0t1MWSnFBucAT+oNmry r
1I2?/2001lRaw.6f06,ypf,q�pg,�J1�,44H5,40116,8178
TEXAS SALES TALC
Texas Sales Tax is charged and collected on sales within the State and City of Grapevine,Texas of"taxable items."Taxable
items include both tangible personal property,specified services. I#'you are in a business that will be selling"taxable items"
within the City of Grapevine,Texas you will be required to collect State and Local Sales Tax in the amount of 8.25%.
A"Seller or Retailer"means a person engaged in the business of malting sales of"taxable items",the receipts from which are
included in the measure of sales or use tax.
The term,"place of business"includes any location at which three or more orders are received by the"Seller or Retailer
in a calendar year.H an order is received at the place of business of a retailer in Texas,but delivery or shipment is made
from a location within the state other than the retailer's place of business. State and local sales tax is due and is allocated to
the city where the order was received.
I have read the above and I understand that I will be required to provide a copy of the Sales Tax Permit to the City of
Grapevine,Texas if the circumstance applies to my business.
�/ IA-
Texas Sales Tax Number:
Signature;
WHER
E DO YOU WANT YOUR.COMPLETED CERTIFICATE OF OCCUP C ?
ADDRESS: 3Zt (,�� 5,,; zao ��`
CITY,STATE,ZIP: •S htrr�w,.� 75"f)
OFFICE USE ONLY*******..*
TYPE OF CONSTRUCTION: q R 1Jv OCCUPANCY: /GAL DIVISION:
ZONING DISTRICT:_ CONDITIONAL USE:
PERMITTED USE: y J
BUILDING DEPARTMENT: f DATE:
BUILDING INSPECTOR: DATE: /0-0
ZONING APPROVAL: _ DATE:
FIRE DEPARTMENT:_ DATE:_� -• }! �(7 �_
LOT DRAINAGE INSPECTION: DATE;
PUBLIC WORKS DEPARTMENT: DATE:
HEALTH DEPARTMENT: DATE:
CITY SECRETARY: DATE:
LANDSCAPING APPROVAL: ,
DATE;_
APPROVAL FOR ISSUANCE: DATE: Q .
0:F( MMOSAPPLICATIONSiC!
91=001/fty.5I06,Zf87,4109,7113,17116,10116,8178
CERTIFICATE OF OCCUPANCY
P � Issue Date:October 21,2020
*7 fi % A' %'t' PROJECT DESCRIPTION:CIO[Medical Office]"Texas Institute for Neurological Disorders"
PROJECT# WWW.mygov.us
CO-20-3592 Permits
City of Grapevine
LOCATION TENANT LEGAL
P.O.Box 95104 1600 W College St. Texas Institute for Baylor Med Ctr Condo
Grapevine,TX 76099
Suite#640 Neurological Disorders Baylor Mad Ctr Condo Units
(817)410-3165 Voice Grapevine,TX 76051 7 Thru 14 Imp Only Medical
(817)410-3012 Fax Off Bldg&Family Clinic
CONTRACTOR INFORMATION
John Nelms *CONSTRUCTION TYPE 1A Sprinklered
321 N.Highland Ave.,Ste.#200 *OCCUPANCY GROUP B-Medical
Nashville,TN 37203-0000 *OCCUPANCY LOAD 12
(903)464-2196 Phone *ZONING DISTRICT PCD
OWNER NAME OF BUSINESS Texan Institute For Neurological
**
Hrt Properties Of Texas Ltd Disorders
3310 W End Ave Ste 700 **TYPE OF BUSINESS Medical Office
Nashville,TN 37203-1097 **APPLICANT NAME John Nelms
AVAILABLE INSPECTIONS **APPLICANT PHONE NUMBER 903-464-2196
P. Final Building C/O Inspection(required) **TENANT NAME John Nelms
► Final Fire Dept Inspection(required) **TENANT PHONE NUMBER 903-893-5141
► Landscaping(required) *Sales Tax NO
► C/O APPROVED FOR ISSUANCE
(required) *Sales Tax Number
Alcoholic Beverage Sales NO
Alterations NO
Change of Business Name NO
Change of Business Owner NO
County Tarrant
Fire Sprinkler System? YES
Freight Forwarding Business NO
Hazardous Material NO
Industrial Waste NO
New Building/Addition NO
New Building or Property Owner NO
New Occupant/Tenant YES
Number of Employees 6
Outside Refuse/Recycling NO
Outside Storage NO
Signs NO
Square Footage 1811
PCD-Planned Commerce
Zoning Development
FEES TOTAL=$50.00
MYGOV.US City of Grapevine I CERTIFICATE OF OCCUPANCY I CO-20-3592 1 Printed 10/22/20 at 8:40 a.m. Page 1 of 3
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. 7 ..TIFICATE OF OCCUPANCY
WORKORDER
PERMIT #20- 3u°1 ,�2-
ADDRESS OF INSPECTION: bi.s
DATE OF INSPECTION: I!. 4ipc TIME OF INSPECTION:
NAME OF BUSINESS:
TYPE OF BUSINESS: w
USE OF BUILDING AND/OR PREMISES: /
REASON FOR APPLYING:
CONTACT PERSON.
TELEPHONE NUMBER.
COMMENTS/VIOLATIONS:
I
I
**TO BE FILLED OUT BY BUILDING OFFICIAL**
ZONING DISTRICT OF INSPECTION LOCATION: OCCUPANT LOAD: 1 2.
TYPE OF BUILDING: j {mac ���/Q//,5 GROUP AND DIVISION: v
ZONING RESTRICTIONS:
O:FORMS DSCOINFORMATION WORKORDER
12 30.04 Rev-1 17 2006
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