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-- CITY OF G EVINE �3
MECHANICAL ELECTRICALS PLUMBING FUEL GAS
PERMIT APPLICATION
(PLEASE PRINT)
PERMIT # � �—
BLDG. PERMIT #
DATE: I A ,
JOB ADDRESS: _ SUITE #
�.
DESCRIPTION OF WORK: �.
PROPERTY OWNER:
CONTRACTING COMPANY:
ADDRESS:
ADDRESS: /IsZ
CITY /STATE /ZIP:
CITY /STATE /ZIP: /
PHONE NUMBER:
PHONE NUMBER: /
/DJUE
TYPE OF OCCUPANCY
BUILDING AREA
(SO FT
PERMIT FEES
AMOUNT
EACH TRADE
I. R -3
1- 749
$ 33.25
SINGLE FAMILY, DUPLEX
750— 1,199
$ 49.88
TOWNHOUSE,
1,200- 1,500
$ 63.18
NEW CONSTRUCTION &
1,501- 1,750
$ 76.48
ADDITIONS (PER UNIT)
1,751- 2,000
$ 83.13
2,001 - 2,250
$ 89.78
TOTAL SQ.FOOT UNDER
2,251- 3,000
$ 96.43
ROOF
3,001- 3,500
$ 103.08
3,501 - 4,000
$ 109.73
$
4,001 +
$ 120.37
EACH TRADE
II. A, E, I, R -1
1 - 500
$ 37.00
HOTELS, APARTMENTS,
501 — 100,000
$ 17.50 +.035 PER
DRINKING /DINING,
100,001 — 500,000
$ 3,500.00 +.03 SQUARE
EDUCATIONAL, ASSEMBLY,
500,001 +
$15,000.00 +.02 FOOT
$
INSTITUTIONAL
EACH TRADE
III. B, F, H, M, S, U
1- 500
$ 37.00
OFFICE, RETAIL, WHOLESALE,
501- 50,000
$ 32.00+.01 PER
1
GARAGES, FACTORIES,
50,001- 100,000
$ 182.00+.007 SQUARE
WORKSHOPS, SERVICE
100,001+
$ 582.00+ .003 FOOT
$
STATIONS, WAREHOUSE
CONTRACT
EACH TRADE
IV. ANY OCCUPANCY GROUP
VALUATION OF
WORK
FINISH -OUTS,
SHELL COMPLETIONS,
0- 500
$ 37.00
ALTERATIONS OR
501- 1,500
$ 45.00
STAND ALONE PERMITS
1,501- 3,000
$ 57.00
CONTRACT VALUATION OF WORK:
3,001- 5,000
5,001- 50,000
$ 72.00
$ 27.00+.009
50,001- 100,000
$ 127.00+ .007 PER
$ lG�%�
100,001- 500,000
500,001+
$ 327.00+ .005 DOLLAR
$ 1,327.00 +.003 VALUATION
EACH TRADE
V. MISCELLANEOUS
IRRIGATION SYSTEMS
$ 37.00
MOBILE HOME SERVICE
$ 37.00
TEMPORARY POLE SERVICE
$ 37.00
SWIMMING POOLS
$ 37.00
SIGN ELECTRIC
$ 37.00
$
O: \FORMS \DS APPLICATIONS - FEES \MEP APPLICATION 4- 11.doc
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.
OTHER INSPECTIONS AND FEES:
• INSPECTIONS OUTSIDE NORMAL BUSINESS HOURS (2HR MINIMUM ) ............................ ...................$42.00 /HOUR"
REINSPECTIONFEES ................................................................................... ............................... $42.00
• PERMITS FOR WHICH NO FEE IS SPECIFICALLY INDICATED.. .......................................... I .... I ......... $37.00
• INSPECTIONS FOR WHICH NO FEE IS SPECIFICALLY INDICATED (112 HOUR MINIMUM) .. ....................$42.00 /HOUR
• ADDITIONAL PLAN REVIEW REQUIRED BY CHANGES, ADDITIONS, OR REVISIONS TO
APPROVEDPLANS .................................................................... ............................... ....................$42.00 /HOUR
• BUILDING PERMIT FEES FOR THE GRAPEVINE - COLLEYVILLE INDEPENDENT SCHOOL DISTRICT
SHALL BE 25% OF THE FEES ESTABLISHED IN THIS TABLE
• FOR USE OF OUTSIDE CONSULTANTS FOR PLAN CHECKING AND INSPECTIONS, OR BOTH......... ACTUAL COSTS "*
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.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
(OR HOMEOWNER FOR HOMEOWNERS PERMITS)
PHONE #:
PRINTED NAME
EMAIL:
'OR THE TOTAL HOURLY COST TO THE JURISDICTION WHICHEVER IS GREATER.
- ACTUAL COSTS INCLUDE ADMINISTRATIVE AND OVERHEAD COSTS.
CITY CIF QRAPFVINF Rtllt_DING INSPECTIONS. P. O. BOX 95104. GRAPEVINE. TX 76099 (817) 410 -3165
6/21/01 REVISED: 10/01, 5/06, 2/07, 7/07, 8109, 11/09, 4/11
O: \FORMS \DS APPLICATIONS - FEES \MEP APPLICATION 4- 11.doc
CITY OF GRAPEVINE PWS i®## 2200013
WATER CUSTOMER SERVICE INSPECTION CERTIFICATION
DATE: C .5 BUILDING
SWIMMING POOL
ADDRESS: (�% L`� � ��( ,
IRRIGATION
PERMIT #: /3 —406 PLUMBING
I hereby certify that I have inspected the water supply system at the above referenced address. To the best of my
knowledge, the materials and methods used in the installation of this system comply with the plumbing code adopted
by the City of Grapevine. Plumbing code is located in Chapter 7, Article VIII, (Ordinance number 92 -17), and Chapter
7, Article V, (Ordinance number 01 -93).
In addition, to the st o n t dge, no cross connection exists at this address at the time of inspection.
SIGNATURE OF INSPE510V LICENSE NUMBER
TITLE
DATE
O: \forms \waterservinsp, 0501
08/03
INSPECTOR