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HomeMy WebLinkAboutCO2020-3751 UNDER CONSTRUCTION CORRECTION LETTER PW OR LID NEEDED TD NO LETTER WAITING FIRE HOLD CODE C/O CHECK LIST C/O PERMIT # P20 - ADDRESS: l BUSINESS NAME: ho—o r \Q-6- (2 BUSINESS ooAe►nr�r ` CHANGE NAME _ NEW CONST/ADDITION PERMIT# NEW TENANT REMODEL/ALTERATION PERMIT# ISSUE DATE FINAL DATE_ 1. APPLICATION FORM COMPLETED XZ 2. ZONING MAP COPIED &WORKORDER FORM COMPLETED .. 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 ✓ 6. BUILDING INSPECTION SCHEDULED DATE TIME 7. FIRE DEPT. INSPECTION SCHEDULED DATE Ili `091 aII TIME I ! , D FIRE INSPECTOR: maxt ,ef:--8. CITY SECRETARY(ALCOHOL) NOTIFICATION DATE: ---'9. HEALTH INSPECTION NOTIFICATION DATE: 0. PUBLIC WORKS INSPECTION E-MAIL DATE_ LOT DRAINAGE INSPECTION E-MAIL DATE 12. CORRECTION LETTER SENT DATE 1/ 13. BUILDING INSPECTORS SIGN OFF LETTER: YES / NO V'14. FIRE DEPARTMENTS SIGN OFF LETTER: YES / NO r! 15. HEALTH DEPARTMENT SIGN OFF ,f�6. CITY SECRETARY(Alcohol License Sign Off) '1�17. PUBLIC WORKS SIGN OFF LOT DRAINAGE SIGN OFF 19. LANDSCAPING SIGN OFF ✓ 20. BUILDING OFFICIALS SIGNATURE I / l ✓21. C/O CERTIFICATE ISSUED ELECTRIC RELEASED: 1Ola` r a� SCAN CERTIFICATE TO MYGOV: 2�2C1 CONDITIONS TO BE TYPED ON C/O? YES/NO MAILED: /t//[^l,live ///20 OIFORMSMSCOINFORMATIOMCKLIST �" �" • 12/30104/R-11111.11115,5118 DATE OF ISSUANCE: !� !� � P E_VI:N�]_Ea 3�l ll E' % ,q PERMIT#: S f CERTIFICATE OF OCCUPANCY REQUEST FEE: $50.00 NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCYIS ASSOCIATED WITHANACTIVE CURRENT BUILDING PERMIT CRl,Aev lov1c-`Zyr r(6 t)s ADDRESS OF OCCUPANCY: f d �eS-7- r �r®m co es-T WW1 SUITE LOT: BLOCK: SUBDIVISION: 1 l l ACIA.`t41 O ""CERTIFICATE OF OCCUPANCY WILL NO BE ISSUED OUT LEGAL DESCRIPTION"" NAME OF BUSINESS: Gr�1 P 0V l M C- � N C u m ft-`0 C u NEW OCCUPANT: YES "+ NO NEW BUILDING/PROPERTY OWNER: YES ✓ NO NEW BUILDING: YES NO NEW BUSINESS NAME CHANGE: YES NO-T NUMBER OF EMPLOYEES: FREIGHT FORWARDING: YES NO M NEW BUSINESS OWNER: YES NO TYPE OF BUSINESS: 1r 1" 1 C A Ir 0 e - \ C — f SQUARE FOOTAGE: 00 (Example:Retail Clothing/Attorney's Office/Office-Warehouse/Restaurant) NAME OF TENANT [PERSON'S NAME]: U�m S. P CURRENT MAILING ADDRESS: - f s Q I (,-,I V\Yq CITY/STATE/ZIP: C a P-C-v(,\j -T (7 6 o_C PHONE NUMBER: 2 PROPERTY OWNER: MAILING ADDRESS: C S lU _._�T U—\`f _p CITY/STATE/ZIP:CAA Pr~V /Iti [ y l7 L0 C l S ` PHONE NUMBER: 3 k 2 tA ♦ 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 ✓ ♦ PERMITS ARE REQUIRED FOR SIGNS. WILD ANY SIGNS BE INSTALLED?------------------- YES ✓ NO ♦ WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM?------YES NO ✓ ♦ WILL OUTSIDE REFUSE/RECYCLING/COMPA TING CONTAINERS BE NECESSARY? (if yes,screening is required)------------------ ---------------------------------------- YES NO �✓ ♦ WILL THERE BE ANY OUTSIDE STORAGE(inclu ng storage of company/fleet vehicles),DISPLAY, USE OR DINING?------------------ -' -------------------------- YES NO Y ♦ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING?------------------------- YES NO ♦ IS BUILDING SPRINKLERED?------------------------------------------------------- YES NO� ♦ WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS? (if yes,provide list of types&quantities,along with material safety data sheets)----------------------YES NO I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF MY KNOWLEDGE AND THE SAID OCCUPANCY IS IN CONFORMANCE WITH THE INFORMATION HEREIN SET FORTH. (If access to the building/space is not provided at the time of the scheduled inspection,a 4�2.00 re-inspection fee will be charged) FOR QUESTIONS P E SE CALL(817)410-3165. SIGNATURE: PRINT NAME: PHONE#: `-r .� L� EMAIL• % Development Services Department The City of Grapevine *P.O.Box 95104* Grapevine,Texas 76099* (817)410-3165 Fax(817)410-3012 ww, rapevinetexas; qv O:FORMSIDSAPPLICATION&V 3/22/20011Rev:5/06,2/07,4/09,2/13,11/15,10/16,8/18 TEXAS SALES TAX 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. If 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 making 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.If 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. Texas Sales Tax"-umber: N Signature: WHERE DO YOU WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED`' ADDRESS: 0 b CITY, STATE, ZIP: _ ' (A PP \r C -T ©` 9 OFFICE USE TYPE OF CONSTRUCTION: lF OCCUPANCY: GOB DIVISION: ZONING DISTRICT: CONDITIONAL USE: PERMITTED USE: / BUILDING DEPART ENT: DATE: BUILDING INSPECTOR: DATE:. �14 ou ZONING APPROVAL: DATE: 1 FIRE DEPARTMENT: DATE: LOT DRAINAGE INSPECTION: DATE: PUBLIC WORKS DEPARTMENT: DATE: HEALTH DEPARTMENT: DATE: CITY SECRETARY: DATE: LANDSCAPING APPROVAL, ��(1-""^-' �_ DATE: APPROVAL FOR ISSUANCE: DATE: (/•21 O:FO RM SIDSAPPLICATIONSICI 3/2 212 0 01/Rev:5/06,2/07,4/09,2/13,11/15,10I16,8/18 ( p'4 n li .ri CERTIFICATE OF OCCUPANCY LIRA .l.l)F Issue Date:October 21,2020 *T F. 3 PROJECT DESCRIPTION:CIO(Medical Office)"Grapevine Rheumatology Clinic" PROJECT# (817)410-3010 www.mygov.us Inspections Permits City of Grapevine LOCATION TENANT LEGAL P.O.Box 95104 Health Research TX LLC Grapevine Rheumatology Capili Addition Ellk 1 Lot 7 Grapevine,TX 76099 7507 W Northwest Hwy. Clinic (817)410-3165 Voice Grapevine,TX 76051 (817)410-3012 Fax CONTRACTOR INFORMATION Ahmar Qureshi *CONSTRUCTION TYPE VB 1501 W.Northwest Hwy. *OCCUPANCY GROUP B-Medical Grapevine,TX 76051 *OCCUPANCY LOAD 32 (312)404-3868 Phone *PERMITTED USE Yes *ZONING DISTRICT HC OWNER **NAME OF BUSINESS Grapevine Rheumatology Clinic Health Research TX LLC **TYPE OF BUSINESS Medical Office 1501 W Northwest Hwy **APPLICANT NAME Ahmar Qureshi Grapevine,TX 76051-3143 **APPLICANT PHONE NUMBER 312-404-3868 ph.(312)404-3868 **TENANT NAME Uzma Syeda AVAILABLE INSPECTIONS **TENANT PHONE NUMBER 312-404-3868 ► Final Building C/O Inspection(required) *Sales Tax NO ► Final Fire Dept Inspection(required) ► Landscaping(required) *Sales Tax Number ► C/O APPROVED FOR ISSUANCE Alcoholic Beverage Sales NO (required) Alterations NO Change of Business Name NO Change of Business Owner NO County Tarrant Fire Sprinkler System? NO Freight Forwarding Business NO Hazardous Material NO Industrial Waste NO New Building/Addition NO New Building or Property Owner YES New Occupant/Tenant YES Number of Employees 6 Outside Refuse/Recycling NO Outside Storage NO Signs YES Square Footage 3200 Zoning HC-Highway Commercial FEES TOTAL=$50.00 Certificate of Occupancy $50.00 MYGOV.US City of Grapevine I CERTIFICATE OF OCCUPANCY I CO-20-3751 I Printed 10/22/20 at 8:57 a.m. Page 1 of 3 y 2 S1pJ g_2 9R1B DD 5 C �R 1�p4 PQQ, \. 4. 5 3A 2 q W q �S^� d�1 �1 ]B o j 1A0 �A04 1 POO �.{y�� Yu�� Y.. } 4 c`.8 ,A 7C 9 5 A f� 3R,Ch 0 A KVB�S 1 GaPPE PRK 1 QL 55 ❑v� R 1 AQQN F°pN +A 6R0�66 '3 , G d� °p6�5 t.z5s� OFF;p'j1k' 20.329� �t.w35 1 h��g3 ® 14gp"11 �6p1 1 WINORTHW,ESTIHWY E SHE 3R ep NE tj.1 _SPOON _ RAP81O tRa 810_ %.J NVFt 3 .8198g F,Q9 5N N 63'29 ,R,A AOg6'% I30.3 3R9R A3xC i ■I•�■ GV� NoRj ��p , 1f'- `� @ �1 t.ns! 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WWo�ODS+AVE.14��QJt EW T �R � �z61"�'= �, �y 1 inch = 400 feet Grid Page: We CERTIFICATE OF OCCUPANCY WORKORDER &-cupq& PERMIT#20-�� ADDRESS OF INSPECTION: DATE OF INSPECTION: 104,14,7 �� TIME OF INSPECTION: lO'3Q NAME OF BUSINESS: Rhe y mGt±o ��L nt C- TYPE OF BUSINESS: Ccl.icaJ _ USE OF BUILDING AND/OR PREMISES: I Ic REASON FOR APPLYING: CONTACT PERSON: TELEPHONE NUMBER: 4-©q-- - co IR COMMENTSNIOLATIONS: **TO BE FILLED OUT BY BUILDING OFFICIAL** ZONING DISTRICT OF INSPECTION LOCATION: OCCUPANT LOAD: �[ TYPE OF BUILDING: GROUP AND DIVISION: ZONING RESTRICTIONS: O:FORMS DSC01NFORMATION WORKORDER 12 30 04 R-1 17 2006 o ■ � £ mot %L ' \b kU § . � �§ / U �_ � 5 lb. 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