HomeMy WebLinkAboutCO2013-2121DATE OF ISSUANCE:
PERMIT #: / / d (
CERTIFICATE F OCCUPANCY
FEE: $50.00
NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCYIS ASSOCIATED WITHANACTIYE CURRENT BUILDLY- GPERAIIT
LOT: K 1 ..V BLOCK: ' SUBDIVISION:
* ** *CERTIFICATE OF OCCUPANCY WILL N�PT BE I5T
NAME OF BUSINESS: `)P Yl f19 S "f-In I
NEW OCCUPANT: YES NO
NEW BUILDING: YES NO
NUMBER OF EMPLOYEES:
TYPE OF BUSINESS: _
(Example: Retail, Office, Warehouse)
NAME OF TENANT:
CURRENT MAILING ADDRESS:
CITY /STATE /ZIP:
PROPERTY OWfNF�
MAILING ADDRESS.
NEW BUILDING/PROPERT
NAME CHANGE: BUSINESS
FREIGHT FORWARDING:
NEW BUSINESS OWNER:
SUITE
DESCRIPTION * * **
OWNER: YES NO _Y
YES _::)�— NO
YES NO E
YES NO
SQUARE FOOTAGE: _ 1 _
PHONE NUMBER: 16
M
CITY /STATE /ZIP: �.. kJ �� j (L
i �DV ~ PHONE NUMBER:
♦ IS YOUR BUSINESS SUBJECT O 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, DISPLAY, USE OR DINING: - - - - - - - - - - - - - - - - - - - - - YES
NO V.
♦ 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 /space is not provided at the time of the scheduled inspection, a $42.00 re- inspection fee will be charged)
FOR QUESTIONS PLEASE CALL (817) 410 -3165. 1
PRINT NAME: ND I I WV4LVJ ( N SIGNAT
PHONE #: %k - C" 1A(Ooo EMAIL:
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (817) 410 -3165
Fax (817) 410 -3012 * www.grapevinetexas.gov
O:FOR,YIS,DSAPPLICATIORS ^C OApplication
3�'22t 2001 /Revi,,d:5;'06,5 /06,2107,4/09
(OVER)
City of Grapevine,
TX
P.O. Box 95104
Grapevine, TX 76099
(817) 410 -3165 Voice
(817) 410 -3012 Fax
CONTRACTOR
CERTIFICATE OF OCCUPANCY
Issue Date: July 1, 2013
PROJECT DESCRIPTION: C/O [Shell Building] "Dennis Roy Peterson" [Change Business Name]
LOCATION TENANT LEGAL
2560 Southwest Grapevine Shell Building Southwest Grapevine Comm
Pkwy. Pk Ad Blk 1 Lot 1111B
Grapevine, TX 76051
CERTIFICATE OF OCCUPANCY
200 S. Main Street
Grapevine, TX 76051
(817) 410 -3158 Phone
OWNER
Dennis & Gayle Peterson
6210 Macduff Dr
Granite Bay, CA 95746 -9684
AVAILABLE INSPECTIONS
► Final Fire Dept Inspection (required)
► Final Building C/O Inspection (required)
► Landscaping (required)
C/O APPROVED FOR ISSUANCE
(required)
INFORMATION
• CONSTRUCTION TYPE VB
• OCCUPANCY GROUP B
• OCCUPANCY LOAD
"ZONING DISTRICT CC
NAME OF BUSINESS
Dennis Roy Peterson
" TYPE OF BUSINESS
Shell Building
* *APPLICANT / TENANT'S NAME
Kay Welborn
* *APPLICANT / TENANT'S PHONE
NUMBER
817- 442 -9600
* *Sales Tax
NO
* *Sales Tax Number
Alcoholic Beverage Sales
NO
Alterations
NO
Change of Business Name
YES
Change of Business Owner
NO
County
Tarrant
Fire Sprinkler System?
NO
Freight Forwarding Business
NO
Hazardous Material
NO
Industrial Waste
NO
New Building / Addition
NO
New Building or Property Owner
NO
New Occupant / Tenant
NO
Number of Employees
Outside Refuse /Recycling
NO
Outside Storage
NO
Signs
NO
Square Footage
9992
Zoning
CC -"Community Commercial
MYGOV.US City of Grapevine I CERTIFICATE OF OCCUPANCY I CO -13 -2121 I Printed 07/01/13 at 2:43 p.m. Page 1 of 3
FEES
TOTAL = $ 21.00
Certificate of Occupancy - NAME CHANGE $ 21.00
PAYMENTS
TOTAL = $ 21.00
CERTIFICATE OF OCCUPANCY (City of
Grapevine Applicant)
Check on 0611212093 ($21.00)
Note: CK8575
READ AND SIGN
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 I space is not provided at the time of scheduled
inspection, a $42.00 re- inspection fee will be charged)
FOR QUESTIONS PLEASE CALL: (817) 410 -3165.
Owner / Agent Signature Date
MYGOV.US City of Grapevine i CERTIFICATE OF OCCUPANCY i CO -13 -2121 I Printed 07/01/13 at 2:43 p.m. Page 2 of 3
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 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: N Ir�-
OFFICE USE ONLY>F>F
TYPE OF CONSTRUCTION: OCCUPANCY: DIVISION:
ZONING DISTRICT: (f C
CONDITIONAL USE:
PERMITTED USE:Cr j
BUILDING DEPARTMENT: DATE: JV`^4l'` -?t jT
ZONING APPROVAL: -''' DATE:
FIRE DEPARTMENT:
DATE:
LOT DRAINAGE INSPECTION: DATE:
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
LANDSCAPING APPROVAL: /?�C
APPROVAL FOR ISSUANCE:
O:SORRISZDSA PPLIC AT10N'StCOApplic.tlon
3/22/2001/Rc,k,d:5,06, 5/06, 2107,4?09
DATE:
DATE:
DATE: ?-1-13
DATE: bj�,j -&I D
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