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Home My WebLink AboutHLP2021-0247 GAP- VINE5 T E x n s January 21, 2021 The attached application is for a Helicopter Lift Request. Please siqn 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 #230 — Ralph Lauren, January 28, 2021 at 7:30 a.m., with a rain date of February 7, 2�t 7:30 a.m. Melanie Hill, Risk Manager Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410-3158 Permit will not be issued until FAA Approval has been received. 01CCOOKOnstruction.lHeli.oterinfo\CoverLetter MEMORANDUM CITY OF GRAPEVINE TEXAS TO: BRUNO RUMBELOW, CITY MANAGER MELANIE HILL, RISK MANAGER FROM: DON DIXSON, ACTING BUILDING OFFICIAL SUBJECT: HELICOPTER LIFT REQUEST DATE: JANUARY 21, 2021 Attached is a reques or a helicopter lift scheduled for January 28, 2021 at 7:30 a.m. for 3000 Gr evine Mills Pkwy #230 {Ralph Lauren) with a rain date of February 7, 2021 at 7:30 a.m. if it meets your approval, please sign below: City Manager Risk Manager -�� 7� 110t� ,W X500 , Building Official TCG-ny-CA -, FAA Approval 0:i000OKVns W ctlonSlHehcopWrlMoVAEMO HELICOPTER LIFT PERMIT Issue Date:January 27,2021 PROJECT DESCRIPTION:Helicopter Lift-January 28,2021 @ 7:30 A.M.with a rain date of February 7,2021 @7:30 a.m."Ralph Lauren" .d PROJECT# (817)410-3010 WWW.m ygov.us HLP-21-0247 Inspections Permits City of Grapevine P.O.Box 95104 LOCATION TENANT LEGAL Grapevine,TX 76099 3000 Grapevine Mills Pk p vry. Ralph Lauren Grapevine Mills Addition Blk 1 (817)410-3165 Voice Suite#230 Lot 1r3 (an)410-3012 Fax Grapevine,TX 76051 CONTRACTOR INFORMATION 5 State Helicopter's —APPLICANT NAME Susan Bitros 285 Blackland Rd. —APPLICANT PHONE NUMBER 9726964009 Fate,TX 75189 (972)636-4009 Phone APPROVAL CITY MANAGER YES APPROVAL DEVELOPMENT SERVICES YES APPROVAL RISK MANAGEMENT YES OWNER County Tarrant Grapevine Mills Mall LIP DATE&TIME OF HELICOPTER LIFT 2021-01-28 07:30 am RAIN DATE FOR HELICOPTER LIFT 2021-02-07 07:30 am Zoning CC-Community Commercial MYGOV.US City of Grapevine I HELICOPTER LIFT PERMIT I HLP-21-0247I Printed 01/27/21 at 2:44 p.m. Page 1 of 1 p.f MECHANICAL PERMIT {VALUE) W1'\E Issue Date:January 22,2021 PROJECT DESCRIPTION:Install 2.25 ton roof top units&1 toilet exhaust fan-Tenant Improvement For f� Simon Properties•Suite#230"Ralph Lauren'[BLDG.20-41061 /F}J PROJECT# (817) 410-3010 www.mygov.us MECH-21-0217 Inspections Permits City of Grapevine P.O.Box 95104 LOCATION TENANT LEGAL Grapevine,TX 76099 3000 Grapevine Mills Pkwy. Ralph Lauren Grapevine Mills Addition Blk 1 (817)410-3165 Voice Suite#230 Lot 1 r3 (817)410-3012 Fax Grapevine,TX 76051 CONTRACTOR INFORMATION Sumners Heating &Air Conditioning, Inc. Is Duct Work Being Installed? NO State ID#TACLB008429E Square Footage 13702 1960 Ridge Crest Place VALUATION 70000 Rockwall, TX 75087 (972)557-1507 Phone FEES TOTAL=$617.00 (972)557-5225 Fax Mechanical Permit Fee{Value} $617.00 (469)446-3627 Mobile PAYMENTS TOTAL=$617.00 OWNER Sumners Heating&Air Conditioning, Inc. (Roy Grapevine Mills Mall LP Sumners) ($617.00) Cc on 0112212021 225 W Washington St Indianapolis, IN 46204-6120 NOTICES ph. (317)636-1600 ALL work must be done in compliance with the 2006 INTERNATIONAL MECHANICAL CODE. AVAILABLE INSPECTIONS � Mechanical Ceiling (required) PLAN SUBMITTAL: WHEN PLANS ARE REQUIRED BY CODES, � Mechanical Final(required) 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 I 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. JAN 2 12021 1 - 0, [L4 ) HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall-Ralph Lauren Polo#230 3000 Grapevine Mills Pkwy Grapevine,TX 76051 NATURE OF OPERATION: Helicopter external lift operation of Roof Top Units to building roof. DATE OF OPERATION: 28 January 2021 with rain date of 7 February 2021 with a 10 day grace period for each date mentioned. I,Shawn Harris,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 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. 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 21st day of Janaury 2021 COMPANY:5-STATE HELICOPTERS, INC. BY:Shawn Harris (printed) SmasHarris TITLE: OWNER (signatur STATE OF TEXAS COUNTYOF Rockwall This instrument was acknowledged before me on this the 21 st day of January 2021 NOTARY PUBLIC IN AND FOR THE STATE Of TEXAS . My commission spires SUSAN BITROS ` =z°�' •`•;k�Notary Publlo,State of Texas Signatur / y;S Comm.Expires 08-26-2024 '' oFrp � Notary ID 132643898 rlyLIMUMN McGriff Certificate of Insurance Certificate No. 113043 Rev.Date:Oct 27,2020 This is to certify that the policy(lea)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 certNcam 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 of the Named Insured shown above Insurer(s): Company Policy No(s). Endurance American Insurance Company through W.Brown and NAC6030702INAF6030703 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. Aut.hrudRcprcWnt&6vc 7525 SE 24th Street,Suite 520,Mercer Island,Washington 98040 Phone:(206)232-9870-Fax:(206)232-9515 285 BLACKLAND ROAD 0SWEFATE,TEXAS 75189 alHELICOPTERS (972)636-4009 January 21, 2021 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: January 28, 2021 Grapevine Mills Mall Ralph Sumners Heating &Air Lauren Polo 7:30AM - 10:OOPM 3000 Grapevine Mills Pkwy 3215 Peachtree Rd. Ste 135 Ste.230 Grapevine, TX 76051 Balch Springs, TX 75180 Helicopter Type: Sikorsky S58T, Kawasaki BK 117, Sikorsky UH-60 TRANSPORT CATEGORY Call Sign: N4XY (Blue), N6BL (Red), N170MC (Yellow) orN112HC (Green) Pilots: Bradford Ladue,Robert Smith,Andrew Smith or Shawn Harris 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: Office@5st• te.com SIN�ERELY, APPROVED/DISAPPROVED BY DATE HELATE RANESEAVICFS DATE: Janaury 21 2021 5z", NR C CAP# 12821 TO: FAA OFFICE North Texas FSDO REFERENCE CONGESTED CONTINGENCY-SAFETY PLAN DATE/TIME.OF JOB JOBSITE.INFORMATION CONTRACTOR INFORMATION DATE: January 28, 2021 ADDRESS: Sumners Heating & Air TIME FRAME: 7 30AM-10:OOAM Grapevine Mills Mall-Ralph Lauren Ste.230 3215 Peachtree Rd ste 135 3000 Grapevine Mills Parkway Balch Springs, TX 75180 Grapevine, TX 76051 JOBSITE CONTACT: Roy Sumners CONTACT: Roy Sumners PHONE NUMBER:: 469-446-3627 PHONE NUMBER: 469-446-3627 **SHOULD A WEATHER, MECHANICAL OR MATERIAL DELAY BE EXPERIENCED,THIS PLAN 15 APPROVED FOR ABOVE LISTED DATE PLUS 14 CALENDAR DAYS. ** AIRCRAFT INFORMATION: 6BL SIKORSKY S-58T TRANSPORT CATEGORY t'44XY SIKORSKYS-58T TRANSPORT CATEGORY N170MC KAWASAKI BK-117 TRANSPORT CATEGORY PILOT INFORMATION: BRAD LADUE COMMERCIAL CERTIFICATE #2760587 ROBERT SMITH COMMERCIAL CERTIFICATE #3493515 ANDREW SMITH COMMERCIAL CERTIFICATE#3893823 SHAWN HARRIS / ATP#2727633 PREPARED BY: Susan BitrOs un® C Stephen Dlgitauy signed by Stephen lames James w:dom Date.2021 01.26 Wisdom 07:5a47-Da00 APPROVED BY: OPERATING CERTIFICATE#LDULS99B 285 BLACKLAND ROAD FATE,TEXAS 75189 (972) 636-4009 ., TATE �HELICOPTEAS MCAAXFSESNSFS LOAD DESCRIPTION HAZMAT: YES X_ (DOT-SP 16606 & DOT-SP 20490) NO XX ROOFTOP UNITS MATERIALS EQUIPMENT OTHER: NUMBER OF TOTAL LIFTS (RANGE) 2 - 10 WEIGHT RANGE 500 - 31000 PERCENTAGE OF LIFT ABILITY OF AIRCRAFT 71% LOAD AERODYNAMIC: YES NO XX LENGTH OF ATTACHING GEAR (FROM HOOK TO BOTTOM OF LOAD) 85' BUILDING OCCUPIED DURING LIFT: YES XX NO (If YES see Narrative) * IF YES, ESTIMATED LOAD PENETRATION OF FLOORS NONE AREA CONSIDERED CONGESTED: YES X_ NO Stephen Digitally signed by Stephen James James Wisdom Date:2021,01.26 Wisdom 07:59:12-06'00' OPERATING CERTIFICATE # LDUL599B 285 BLACKLAND ROAD FATE,TEXAS 75189 (972) 636-4009 5 IL HELICOPTERS NACAANESEAVICFS CONGESTED COMMERCIAL AREA CONGESTED RESIDENTIAL AREA XX CONGESTED AREA PROBABILITY/POSSIBILITY This is congested area operations. 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 a 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 in a residential and commercial area we classify this to be a potential congested area. However, all entrances will be blocked and controlled by security personnel so that no unauthorized persons shall enter or cross the operational area. The building (inside the operational area) will be vacant during operations. 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