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Home My WebLink AboutPLBG2020-2558City of Grapevine P O. Box 95104 Grapevine, TX 76099 (817) 410-3165 Voice (817)410-3012 Fax CONTRACTOR SMR Plumbing State ID # 39571 P. O. Box 560111 The Colony, TX 75056 (469)556-5288 Phone (469)574-5579 Fax ( smr1919@att.net OWNER Grapevine Mills Mall Lp 225 W Washington St Indianapolis, IN 46204-6120 ph. (317) 636-1600 PLUMBING PERMIT (VALUE) Issue Date: July 22, 2020 PROJECT DESCRIPTION: Install 1/2N# RPZ for soda machine PROJECT # (817) 410-3010 www.mygovms PLBG-20-2558 Inspections Permits LOCATION TENANT LEGAL 3000 Grapevine Mills Pkwy. Cajun Grille 1grapevine Mills Addition Bilk Suite # FC5 1 Lot 1r3 Grapevine, TX 76051 Cajun Grille AVAILABLE INSPECTIONS L Backflow Device Inspection (required) i, TCEQ Backflow Certification Submit (required) i, Plumbing Final (required) INFORMATION County Tarrant Square Footage 110 VALUATION 2500 Zoning CC - Community Commercial FEES TOTAL = $ 57.00 Plumbing Permit Fee {VALUE) $ 57.00 PAYMENTS TOTAL e $ 57.00 SMR Plumbing (San Martin Reyna) ($57 00) Cc on 07/22/2020 NOTICES ALL work must be done in compliance with the 2006 INTERNATIONAL PLUMBING CODE. 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. MYGOV US City of Grapevine I PLUMBING PERMIT (VALUE] I PLBC-20-2558 I Printed 08/03/20 at 2 39 p.m Page 1 of 3 AU G 3 2020 Texas Commission on Environmental Quaiity BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT The following form must be completed for each assembly tested. A, si,¢ned �ajnd dated original must be submitted to the public water supplier for recordkeepinlg *purposes: J NAME OF PWS: I C4gV1JG_/C- LE PWS ID#: ;Z100 f3 1 PWS MAILING ADDRESS: I $00 �Q jjJ000fC l PWS CONTACT PERSON: lI jj'� G"6�. Pr-t.I _ _ ,� f''• I ADDRESS OF SERVICE: TWO G GVI JAIL- r WKY ►'G� fat P6 A 44r( The backflov prevention assembly detailed below has been tested and maintained as required by commission regulations and is certified to be operating within acceptable parameters. _ _ 'TYPE OF BACKFLOW PREVENTION ASSEMBLY (BPA): [' Reduced Pressure Principle (RP BA) ❑ Reduced Pressure Principle -Detector (RPBA-D) ❑ Double Check Valve (DCVA) ❑ Double Check -Detector (DCVA-D) ❑ Pressure Vacuum Breaker (PVB) ❑ 1 Spill -Resistant Pressure Vacuum Breaker (SVB) Manufacturer: 100 I Size: Model Number: - .5$ OOaI M ,7 BPA Location: Serial Number: K} 0O 2 `BPA Serves: , SQ U I} J✓rifj i; Reason for test: I New Ll! j Existing ❑ I Replacement ❑ Old Model/Serial # Is the assembly installed in accordance with manufacturer recommendations and/or local codes? Yes []No Is the assembly installed on a non -potable water supply (auxiliary)? � ❑ Yes ` 2'� o TEST RESULT PASS / Reduced Pressure Principle Assembly (RPBA) DCVA FAIL ❑ I" Check 1 2r' Check*** Initial Test Date: pp,o3,10;tO i Time: 1 Z•, DO ,Repairs and Materials Used" Held at 1, ftopsi Held atq: ipsi( Closed Tight Z Closed Tight Q Leaked ❑ ILeaked ❑ Test After Reuair Held at — psid Held at _ psid Date: Closed Tight ❑ JjClosedTight ❑ ,Time: *** 2n° check: numericr [Differential pressure gauge used: H Make/Model: JW)U4jpoS 1 ,S Remarks: Relief Valve Opened at 'j'1'psid Did not open ❑ PVB & SVB Air fillet Check Valve 14 Opened at ` Held at psid psid Leaked ❑ Didnotopen ❑ Did it fully open (Yes ❑ /No ❑) Opened at _psid Opened at ��eId at+ psid psid - 1 ling required for DCVA one _ Potable: ElSN__�I Non -Potable: U2 JQ _Late.tested for accuracy_ { , Company Name: Licensed Tester Name 1 .S'?�j/. fµQlNti I ��on %1Zmrt1"n ��nq (Print/Type): Company Address: 1$'?S W4WSr- Licensed Tester Name (Si ature): Company Phone #: 1 jK BPAT License # /nn Qb. License Expiration Date: 0:;-. . The above is certified to be true at the time of testing. * TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS [10 TAC §290.46(B)l ** USE ONLY MANUFACTURER'S REPLACEMENT PARTS TCEQ-20700 (Revised 7-31-2018) Page 1 of I