HomeMy WebLinkAboutCO2021-2516UNDER CONSTRUCTION _
CORRECTION LETTER _
PW OR LID NEEDED _
TD NO LETTER _
WAITING FIRE _
HOLD _
CODE
C/O CHECK LIST
C/O PERMIT # P21 - 3-�; t lv
ADDRESS: �-� �6-Cx C- BUD r;�; A\} C
BUSINESS NAME: Cl,l'e//k 0 3 ,k i-,u)
BUSINESS/PROPERTY
CHANGE NAME / OWNER _ NEW CONST / ADDITION PERMIT #
NEW TENANT / OCCUPANT REMODEL / ALTERATION PERMIT #
ISSUE DATE FINAL DATE
1. APPLICATION FORM COMPLETED
__�L2. ZONING MAP COPIED & WORKORDER FORM COMPLETED
i 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 %/-2( TIME
7. FIRE DEPT. INSPECTION SCHEDULED DATE TIME vv
FIRE INSPECTOR:
8.
CITY SECRETARY (ALCOHOL)
NOTIFICATION DATE:
9.
HEALTH INSPECTION
NOTIFICATION DATE:
0.
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
_,e�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
LOT DRAINAGE SIGN OFF
19.
LANDSCAPING SIGN OFF
✓/20.
BUILDING OFFICIALS SIGNATURE
21.
C/O CERTIFICATE ISSUED
ELECTRIC RELEASED:
SCAN
CERTIFICATE TO MYGOV:
�K CONDITIONS TO BE TYPED ON C/O? YES / NO
_
MAILED:
O WORMS\DSCOINFORMATIONICKLIST
12I30I041 Rev 1 ttltp R15.5I18
t
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�vrl-
DATE OF ISSUANCE:
PERMIT #: �J 1 in
CERTIFICATE OF OCCUPANCY REOUEST
FEE: $50.00
NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITH AN ACTIVE CURRENT BUILDING PERMIT
ADDRESS OF OCCUPANCY: 33 �1 ITc, � h• ,,zh SUITE # /
LOT: 1 i ` BLOCK: SUBDIVISION: DFt) Bock' k' /Less 9� k AAA,
****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION****
NAME OF BUSINESS: (+ S kDLO
NEW OCCUPANT: YES NO ✓ NEW BUILDING/PROPERTY OWNER: YES NO ✓
NEW BUILDING: YES NO _� NEW BUSINESS NAME CHANGE: YES NO ✓
NUMBER OF EMPLOYEES: — FREIGHT FORWARDING: YES NO
NEW BUSINESS OWNER: YES NO ✓
TYPE OF BUSINESS: V C avt -I-'- SQUARE FOOTAGE: � tqo?
(Example: Retail Clothing/ Attorney's Office/Office-Warehouse/Rests rant)
NAME OF TENANT [PERSON'S NAME]: Ma \ ct 1 oe !2VV .,
CURRENT MAILING ADDRESS: 2 —tom Ira t- (- 1zz
CITY/STATE/ZIP: & Npji4.Q 1/x 7(PD 1 PHONENUMBER: YlIMip
PROPERTY OWNER: �nn—� f1 q ih� elf f1��1.+3 CL C
MAILING ADDRESS: vO
CITY/STATE/ZIP: )tAx-Yl.,vo(o PHONE NUMBER: �)% ✓�j 3`/�J'
♦ 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,
USE OR DINING?------------------------------------------------------------------ YES _ NO
♦ 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/spac s not provided at the time of the scheduled inspection, a S42.00 re -inspection fee will be charged)
FOR QUESTION L ASE/ C L (817) 410-3165. ��y,
SIGNATURE: i l L f t? PRINT NAME:_/�41Oil 1/! ,?A4 �fl[
PHONE #: C, % 76 6 3 a7 EMAIL: ?0
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (817) 410-3165
Fax (817) 410-3012 * www.eraoevinetexas.eov
3120a1/Rev:51N,V07,4N8,Vl3,11115,10/16,6118,10120
TEXASSALESTAX
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.
Texas Sales Tax Number:
Signature: \ I�/
WHERE DO YOU WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED?
ADDRESS:
CITY, STATE, ZIP:
OFFICE USE
TYPE OF CONSTRUCTION:
ZONING DISTRICT: G61
PERMITTED USE: l /. / S/Dcc�
BUILDING DEPARTME
BUILDING INSPEC O'� J
ZONING APPROVAL:
FIRE DEPARTMENT:
LOT DRAINAGE INSPECTION:
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
CITY SECRETARY:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE:
O.FORMS\OSAPPLICATIONS-FEES
32001/Rev. 5/06,V07,4M9,Wl3,11115,10AB,8118,10/20
OCCUPANCY: 9DA/f,- DIVISION:
CONDITIONAL USE: -NA
OCCUPANT LOAD:-AIPA/IF�
DATE: %-Zt-Z(
DATE: 712GIJ,�
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:!
DATE: / 2—/
i
DATE: Z
_
CERTIFICATE OF OCCUPANCY
1'tl.
Issue Date: August 3, 2021
`b17L"11;I` t `L�
PROJECT DESCRIPTION: CIO "Clean S Show"
PROJECT # (817) 410-3010
CO-21-2516 Inspections
City of Grapevine
LOCATION TENANT
P.O. Box 95104
2321 Ira E Woods Ave. Clean & Show
Grapevine, TX 76099
Suite # 120
(817) 410-3165 Voice
Grapevine, TX 76051
(817)410-3012 Fax
CONTRACTOR
Dawn Przybylski
1650 W. Northwest Hwy.
Grapevine, TX 76051-0000
(817)337-3433 Phone
OWNER
Lie Aa Investments Llc
718 Muir Or
Mountain View, CA 94041
AVAILABLE INSPECTIONS
Final Building C/O Inspection (required)
* Landscaping (required)
. C/O APPROVED FOR ISSUANCE
(required)
INFORMATION
* CONSTRUCTION TYPE
* OCCUPANCY GROUP
* OCCUPANCY LOAD
• PERMITTED USE
* ZONING DISTRICT
** NAME OF BUSINESS
•* TYPE OF BUSINESS
**APPLICANT NAME
*APPLICANT PHONE NUMBER
**TENANT NAME
**TENANT PHONE NUMBER
*Sales Tax
*Sales Tax Number
Alcoholic Beverage Sales
Alterations
Change of Business Name
Change of Business Owner
County
Fire Sprinkler System?
Freight Forwarding Business
Hazardous Material
Industrial Waste
New Building / Addition
New Building or Property Owner
New Occupant) Tenant
Number of Employees
Outside Refuse/Recycling
Outside Storage
Signs
Square Footage
Zoning
FEES
Certificate of Occupancy
www. mygov. us
Permits
LEGAL
D F W Business Park Addition
Elk 1 Lot 9a
II-B Spnnklered
NONE
NONE
CLEAN A
CC
Vacant
Clean & Show
Dawn Przybylski
817-793-0327
Vacant
817-337-3433
NO
NO
NO
NO
NO
Tarrant
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
2482
CC - Community Commercial
TOTAL = $ 50.00
$ 50.00
MYGOV US City of Grapevine I CERTIFICATE OF OCCUPANCY I CO-21.25161 Primed 08/04/21 at 8,09 a, in Page 1 of 3
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CERTIFICATE OF OCCUPANCY
WORKORDER
PERMIT # 21 - 1 i5,1
ADDRESS OF INSPECTION:
0
DATE OF INSPECTION: 1 n �-a �- a 1 TIME OF INSPECTION:
NAME OF BUSINESS: ��,Cin A S1�U
TYPE OF BUSINESS:
USE OF BUILDING AND/OR PREMISES:
REASON FOR APPLYING:
CONTACT PERSON: 14 b1� S k l
TELEPHONE NUMBER:
COMMENTS/VIOLATIONS:
r U J
**TO BE FILLED OUT BY BUILDING OFFICIAL**
ZONING DISTRICT OF INSPECTION LOCATION: OCCUPANT LOAD: &10A(P,
TYPE OF BUILDING: // - pj al P�inl�S GROUP AND DIVISIONa�,„f li C�Gw
ZONING RESTRICTIONS:
14A
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