HomeMy WebLinkAboutCO2021-1688UNDER CONSTRUCTION _
CORRECTION LETTER _
PW OR LD NEEDED _
TD NO LETTER _
WAITING FIRE _
HOLD _
CODE _
C/O CHECK LIST AlOr
C/O PERMIT # P211 /-
`-/
ADDRESS: /
BUSINESS NAME:��
v
BUSINESS/PROPERTY U
CHANGE NAME / OWNER _ NEW CONST / ADDITION PERMIT #
-NEW TENANT / OCCUPANT -REMODEL / ALTERATION PERMIT #
ISSUE DATE FINAL DATE _
�1. APPLICATION FORM COMPLETED
p- /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
6. BUILDING INSPECTION SCHEDULED DATE TIME
7. FIRE DEPT. INSPECTION SCHEDULED DATE 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
19. LANDSCAPING SIGN OFF
20. BUILDING OFFICIALS SIGNATURE
21. C/O CERTIFICATE ISSUED ELECTRIC RELEASED:
SCAN CERTIFICATE TO MYGOV:
CONDITIONS TO BE TYPED ON C/O? YES / NO MAILED.
O \FORMSIOSCOIN FORMNTIOMOKLIST
121]01041 Rev.11)11 1 V 15 5 18
AY 17 2021
DATE OF ISSUANCE: / / b p (/
PERMIT #: t? /— / O (y
CERTIFICATE OF OCCUPANCY REQUEST,
FEE: $50.00
NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITH AN ACTIVE CURRENT BUILDING PERMIT
ADDRESS OF OCCUPANCY: v/,"1.l v b d/ii�''// cirJITE#
LOT: %1 BLOCK: I SUBDIVISION: �a� iw Wt gjtA M i-F * AW
****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED THOUT EGAL DESCRIPTION****
NAME OF BUSINESS: lfa i, AV_ _ �OGtk'
NEW OCCUPANT: YES V NO NEW BUILDXG/PROPERTY OWNER: YES NO ✓
NEW BUILDING: YES _ NO 7— NEW BUSINESS NAME CHANGE: YES ✓ NO ✓
NUMBER OF EMPLOYEES: FREIGHT FORWARDING: YES NO V
q NEW BUSINESS OWNER: YES NO
TYPE OF BUSINESS: _� ��Y 171 SQUARE FOOTAGE: I t-lg7
(Example: Retail Clothing / Attorney's Office / Rice -Warehouse / Restaurant)
NAME OF TENANT [PERSON'S NAME]: /r /
CURRENT MAILING ADDRESS: L7 �� (i`'tGUa (,G�ILI�i_ii4M
CITY/STATEIZE': ���J7 176]VCz1 PHONE NUMBER:
PROPERTY OWNER: (raPlva l'd-
MAILING ADDRESS: �OdWt)VL4 1dd A/J, U
CITY/STATE/ZIP: type
�
I L ` Ol Q I I,--- PHONE NUMBER:
r
♦ 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. WILL ANY SIGNS BE INSTALLED? - - - - - - - - - - - - - - - - - - - YES NO
♦ WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? - - - - - - YES —NO
♦ WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY?
(if yes, screening is required)- - - - - - - - - - - - - - - - - - - - YES — NO
♦ WILL THERE BE ANY OUTSIDE STORAGE (including storage of company/fleet vehicles), DISPLAY, '
USEOR DINING? ------------------------------------------------------------------ YES_NO_
♦ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? - - - - - - - - - • - - - - - - - - - - - - - - - YES _ NO l
♦ 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 buildi space is not provided at the time of the scheduled inspection, a S42.00 re -inspection fee will be charged)
FOR QUESTIONS C LL (817) 410-M65.
SIGNATURE: 7 i /� r /�y> PRINT NAME:
PHONE #: ! 1191 1 J � "l V EMAIL: ZW
(� (OVER)
Department
The City of Grapevine * P.O. Box 95104 Grapevine, Texas 76099 * (817) 410-3165
Fax (817) 410-3012 * www.graoevinetexas.eov
O:FORM E)SAPPLICATION&FEES
3/2001/Rev:5/06,2/07A/09,2/13,11/15,10/16,6/18,16/20
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 5.25%.
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.
Tex:
Sign
ADDRESS: [.9 1
CITY, STATE, ZIP:
OFFICE USE
TYPE OF CONSTRUCTION:
OCCUPANCY: DIVISION:
ZONING DISTRICT•
CONDITIONAL USE:
' '`w,�
A/ PERMITTED USE:
OCCUPANT LOAD:
BUILDING DEPARTMENT: —
DATE:
BUILDING INSPECTOR:
DATE:
ZONING APPROVAL:
DATE:
FIRE DEPARTMENT:
DATE:
LOT DRAINAGE INSPECTION:
DATE:
PUBLIC WORKS DEPARTMENT:
DATE:
HEALTH DEPARTMENT:
DATE:
CITY SECRETARY:
DATE:
LANDSCAPING APPROVAL:
DATE:
APPROVAL FOR ISSUANCE:
DATE:
O:FORMS DSAPPLICATION&FEES
3/2001/Rev:5/06,2/07,M09,2/13,11/15,10/16,6/16,10/20
9S b-ZELZ
O e.-jW"1i ;.o��4
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990-9zlz
9S4-OZLZ
494-ZELZ 494-9Z2
b94-OZIZ
CERTIFICATE OF OCCUPANCY
WORKORDER
PERMIT # 21 -
/
ADDRESS OF INSPECTION: `7'/ 1 �
DATE OF INSPECTION: TIME OF INSPECTION:
i
NAME OF BUSINESS: jay -�,
TYPE OF BUSINESS: _ r a-L,. -
USE OF BUILDING AND/OR PREMISES:Q_.)
REASON FOR APPLYING
CONTACT PERSON:
TELEPHONE NUMBER: 14? /Z/
COMMENTS/VIOLATIONS:
**TO BE FILLED OUT BY BUILDING OFFICIAL**
ZONING DISTRICT OF INSPECTION LOCATION:
TYPE OF BUILDING:
ZONING RESTRICTIONS: us ace
GROUP AND DIVISION:
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