HomeMy WebLinkAboutCO2021-2640UNDER CONSTRUCTION _
CORRECTION LETTER _
PW OR LD NEEDED _
TD NO LETTER
WAITING FIRE _
HOLD _
CODE
C/O CHECK LIST
C/O PERMIT # P21 USr' MT �n
ADDRESS:
BUSINESS NAME: y� % �''�JO, ,� `��o��jLq
BUSINESS/PROPERTY
CHANGE NAME / OWNER _ NEW CONST / ADDITION PERMIT #
, NEW TENANT / OCCUPANT REMODEL / ALTERATION PERMIT #
ISSUE DATE FINAL DATE
_ 1. APPLICATION FORM COMPLETED
>/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
V 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
V 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 1FORMSIOSCOINFORMNTIOMCKLI97
12I301 1 Rev.t m 1,1 1k15.5n8
111 2 S 2221
DATE OF ISSUANCE:
PERMIT
CERTIFICATE OF OCCUPANCY REOUEST
FEE: $50.00
NO FEE REQUIRED IF CERTTFICATE OF OCCUPANCPISASS0124TED WITSANACME CURRENT BUILDING PERMIT
ADDRESS OF OCCUPANCY: F (,)AL(- `7- SUITES #
LOT: C BLOCK: SUBDIVISION:`'t� %//';,�
*'***CERTIFICATE OF OCCUPANCY WILL NOT BE ISST7EH WITHOUT LEd{AL DESCRIPTION**a*
NAME OF BUSINESS: ILLT I~ L E CT-i�-i C
NEW OCCUPANT: YES `- NO NEW BUILDING/PROPERTY OWNER. YES NO Y,
NEW BUILDING: YES _ NO _is_ NEW BUSINESS NAME CHANGE: YES NO S-
NUMBER OF EMPLOYEES: CN FREIGHT FORWARDING: YES NO X
NEW BUSINESS OWNER: YES NO Z_
TYPE OF BUSINESS: �t Solt I C INN SQUARE FOOTAGE: i ,SD
(Example: Retail Clothing/Attorney'so Ice) ,ce- areLousc/Restaurant)
NAME OF TENANT (PLRSON'S NAYEJ: 5N1^1n knM 1 ICCR
CURRENT MAILING ADDRESS: (00 C H-L: / � �CXl
FfIi CITY/STATE/ZIP:GVlt')r I ��(��} PHONENUMBER: -SS�-GIoZ jR
PROPERTY O WNER: C) v 14-reo C) Pc 0 m V'� L C. C
MAILING ADDRESS:) �.� �� 6
/
CITY/STATE/ZIP: l l U\ (?C V ( )1`: I TX -7A (-)S I PHONE NUMBER: ()
♦ IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate) - - - - YES X NO _
• WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes, provide copy of Alcoholic Beverage Permit) - YES _NO ')(I
♦ PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? ------------------- YES NO X
• WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? - - - - - YES — NO
♦ WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY?
(if screeningisre uired------------------- (' es ' b 4 ) - - - - 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
• IS BUILDING SPRINI LERED?------------------------------------------------------- YES NO
♦ WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS?
(if yes, provide list of tyres & 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 $42.00 re -inspection fee will be charged)
FOR QUESTION4
_PLEASE 0-3165.
SIGNATUPRINT NAME: `:3\AW7--Y cC
Z
PHONE #: ) � ^ �IO�' � �j EMAIL: 15 R Al�we-
City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (S 3 7) 410-3165
Fax (917) 410-3012 * cmnNw�, .Taney netexaseov
O:FORMSIOSAPPLICATIONSWI
=2120U11Rev: 5106.2107,4109,2H3,11115, 10118
EXAS 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 Number:
Signature: �( 1A
WHERE. DO YOU WANT YOUR COMP1,ETED CERT IFICATE OF OCCUPANCY :RAILED?
ADDRESS: L/ n nE
CITY, STATE, ZIP:
TYPE OF CONSTRUCTION:
ZONING DISTRICT:
PERMITTED USE:
BUILDING DEPARTMENT:
BUILDING INSPECTOR. -
ZONING APPROVAL:
FIRE DEPARTMENT:
LOT DRAINAGE INSPECTION:
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
CITY SECRETARY:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE:
OFFICE USE
OCCUPANCY: DIVISION:
CONDITIONAL USE:
DATE:
DATE:
DATE:
DATE:
DATE.
DATE:
DATE:
DATE:
DATE:
DATE:
0:F0WSWSAPPUCATI0NSICi
3=2001M. 3/06=7AINX13.11115, 10H6
TEXAS SALES AND USE
Thls permit is not transferable, and this side must be promin
TAX PERMIT
ltly displayed in your place of business.
Aefarfers: r salter mey.NOT,
ccapt a cop yofthis permit Inleu If properlycompleted elrmphon or
resale cendicala. Acerttricata is ra+cessary fo document whyfexis not collected on a sale. You must obtain a new permR rf there is a change of
7
TAXPAYER NAME BUSINESS LOCATION NAME, and PHYSICAL LOCATION °LY°ership, location, or business location name.
KLT ELECTRIC, LLC Type olpermrt
SALES AND USE TAX
KILT ELECTRIC Ta ryayer number
1890 N KIMBALL AVE
SOUTHLAKE TX 76092-4004 I00001
Locabonnumber
TA RANT COUNTY - _J _ �on
— f _
NAICS: 238210 Electrical Contractors and Other Wiring Installation Contrac F,r—Iness sate of locatiJI{
WE SHOW THIS BUSINESS IN THE FOLLOWING LOCAL SALES TAX AUTHORITIES: 04/01/2015
CITY: SOUTHLAKE EFF: 04/01/2015
SPD: SOUTHLAKE CRIME CONTROL EFF: 04/01/201.5
Glenn Hegar
- Comptroller of Public unts
You may need to collect sales and/or use tax for other local tabng authorities depending on Your type of business.
For additional information, see "Collecting Locat Sales and Use Tax" section on the back oft his document.
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CERTIFICATE OF OCCUPANCY
WORKORDER
PERMIT # 21
ADDRESS OF INSPECTION: /-//) 3 Cr Jar per'
DATE OF INSPECTION:
TIME OF INSPECTION:
NAME OF BUSINESS:
TYPE OF BUSINESS:
USE OF BUILDING AND/OR PREMISES: o , V
REASON FOR APPLYING:
CONTACT PERSON:
��1�
TELEPHONE NUMBER:
COMMENTS/VIOLATIONS:
**TO BE FILLED OUT BY BUILDING OFFICIAL**
ZONING DISTRICT OF INSPECTION LOCATION: OCCUPANT LOAD:
TYPE OF BUILDING:
ZONING RESTRICTIONS:
GROUP AND DIVISION:
0 FORMS DSCO1RPORAIATION' ORFORDER
12"1ONRev I I]21ID6