HomeMy WebLinkAboutCO2013-1217DATE OF ISSUANCE:
PERMIT #:
12) —(-�_ �-I
CERTIFICATE OF OCCUPANCY REQUEST
FEE: $50.00
NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCYIS ASSOCIATED WITH AN ACTIVE CURRENT BUILDING PERMIT
ADDRESS OF OCCUPANCY: 1400 W' L'`DL#_ cc .x -Sr. SUITE # l >
LOT: #-is BLOCK t SUBDIVISION: P'AX14
* ** *CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION""
NAME OF BUSINESS Y11-01 MAMA P' r•'iARIIJACY Ar rF_vtWe
NEW OCCUPANT: YES V" NO NEW BUILDING/PROPERTY OWNER: YES NO
NEW BUILDING: YES NO _/ NAME CHANGE: BUSINESS YES NO
NUMBER OF EMPLOYEES: 4 FREIGHT FORWARDING: YES NO
NEW BUSINESS OWNER: YES NO
TYPE OF BUSINESS: 14-m u_ )'HA It MA c-Y SQUARE FOOTAGE: _ 1890
(Example: Retail, Office, Warehouse)
NAME OF TENANT: 13AYLoIL triEA L..T# N mrst is fr't a 6VrFATrf_4r 'f"llA tm,-,e_Y AT 4!�1tit- F_viWF_
CURRENT MAILING ADDRESS: 1/r/ )4. 1�Ha4 ,t
CITY /STATE /ZIP: t 75*Z44 PHONE NUMBER: �7 " -ep
PROPERTY OWNER: to u-ne -ARE. 1rr-.oi.rY
MAILINGADDRESS: -9`00 Sv91V5, ._5�r Sv 17-r— 4qb
CITY /STATE /ZIP: > A Lj-AS , `TX *7s -z4(. PHONE NUMBER: +Z 14 - 747 - /&O p
IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate) - - - - YES V4 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
a WILL THERE BE ANY OUTSIDE STORAGE, DISPLAY, USE OR DINING: - - - - - - - - - - - - - - - - - - - - - YES NO
♦ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? - - - - - - - - - - - - - - - - - - - - - - - - - YES s% NO
i IS BUILDING SPRINKLERED?-------------------------- ----------------------- - - - - -- YESPeNO
* 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.
PRINT NAME: T> "� IF+MA+ { SIGNATURE:
PHONE #: /'q EMAIL:
1
O; Fo &NiSOWFUCAit0?Z5\CIOAppllcati..
V179001fflni edWN,R",. M7004
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76094 * (817) 410 -3165
Fax (817) 410 -3012 * www.grapevinetexas.gov
(OVER)
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 properly, 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: 1 — 7-1- " 4 +7X78 —,Z � co-
6x C (_3 Uri i1_
Signature: 1
. 1 1,
CITY, STATE, ZIP:
�t�FOR OFFICE USE (NLY>stt
TYPE OF CONSTRUCTION: r 511OCCUPANCY: 2 DIVISION:
ZONING DISTRICT: CONDITIONAL USE:
PERMITTED USE: vlf''i
BUILDING DEPARTMENT: _ DATE: rp "Z� � /I�
ZONING APPROVAL: DATE:
FIRE DEPARTMENT: C r L �' DATE :�
LOT DRAINAGE INSPECTION: DATE:
PUBLIC WORKS DEPARTMENT: ~� DATE:
HEALTH DEPARTMENT: _t-� DATE:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE:
q; FOR1ISIDSAPP41CATtoNS 'iClt)Apptlaiian
3t3:n8611ROWd 06, SM, U7,4109
DATE:
DATE:
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 Retaller" means a person engaged in the business of inaldng sales of "taxable Items ", the receipts from which are
included in the incasure of sales or use tax,
The tern), "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 react 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 illy business.
Texas Sales Tax Number: 1-7V— { 71 7 71 "" Ll-�-
a
.Signatul
ADDRE88: t i6 0 Uo-4 Co I l o c o y , Si-re.,aA --, is, U_;, A - - - 1 1 0
CITY, STATE, ZzP: �'raee 4 ; n.e.
s; s':drlt tk.tS�txti ns$A trot x k.hatkk t kxx:� '� i OFFICE' USE,
TYPE OR CONSTRUCTION:
ZONING DISTRICT:
PERMITTED USE:
BUILDING DEPARTMENT;
ZONING APPROVAL:
FIRE DEPAR'T'MENT:
LOT DRAINAGE INSPECTION:
PUBLIC WORKS DEPARTMENT:
HEALTH IIEPARTRIENT:
LANDSCAPING APPROVAL:._
APPROVAL FOR ISSUANCE:
Oti4St�19.U5AP pi.IC,�7loi scAAFpt�ai m
a�71J209u7MSied:Y�. SCfi. �n7,a^ct
OCCUPANCY: DIVISION:
CONDITIONAL USE:
DATE:
DATE:
DATE,:
DATE:
DATE:
DATE:
DATE:
DATE:
CERTIFICATE OF OCCUPANCY
Issue Date: July 1, 2013
PROJECT DESCRIPTION: C/O (Retail Pharmacy) "Baylor Plaza Pharmacy At Grapevine" [BLDG -13 -0953]
City of Grapevine,
TX LOCATION
1600 W College St
P.O. Box 95104
Grapevine, TX 76099 Suite # 110
Grapevine, TX 760
(817) 410 -3165 Voice
(817) 410 -3012 Fax
CONTRACTOR
CERTIFICATE OF OCCUPANCY
200 S. Main Street
Grapevine, TX 76051
(817) 410 -3158 Phone
OWNER
Grapevine Medical Center
3201 Worth St #201
Dallas„ Tx 75226 -0000
ph. (000) 000 -0000
AVAILABLE INSPECTIONS
► Final Fire Dept Inspection (required)
► Final Building C/O Inspection (required)
► Landscaping (required)
► C/O APPROVED FOR ISSUANCE
(required)
TENANT
Baylor Plaza Pharmacy At
Grapevine
51
LEGAL
Grapevine Medical Center
Addn Blk 1 Lot 11 -B
Baylor Medical Center Tr 1
Acres 0.0000
INFORMATION
* APPLICATION STATUS
Approved
* CONSTRUCTION TYPE
IA Sprinklered
* OCCUPANCY GROUP
12
* ZONING DISTRICT
PCD
** NAME OF BUSINESS
Baylor Plaza Pharmacy at Grapevine
** TYPE OF BUSINESS
Retail Pharmacy
"APPLICANT/ TENANT'S NAME
Courtney Tyree
* *APPLICANT / TENANT'S PHONE
NUMBER
817- 424 -4806
* *Sales Tax
YES
* *Sales Tax Number
000
Alcoholic Beverage Sales
NO
Alterations
YES
Change of Business Name
YES
Change of Business Owner
NO
County
Tarrant
Fire Sprinkler System?
YES
Freight Forwarding Business
NO
Hazardous Material
NO
Industrial Waste
NO
New Building / Addition
NO
New Building or Property Owner
NO
New Occupant / Tenant
YES
Number of Employees
Outside Refuse /Recycling
NO
Outside Storage
NO
Signs
YES
Square Footage
2890
Zoning
PCD - Planned Commerce
MYGOV.US City of Grapevine I CERTIFICATE OF OCCUPANCY I CO -13 -1217 I Printed 07/01/13 at 3:05 p.m. Page 1 of 3
' {�a TEXAS SALES AND USE TAX PERMIT
This permit is not transferable, and this side must be prominently displayed in your place of business.
4 ark s gr ray l lz s per`t»rt In heir of a properly corrrptafed eze rnptiori or You miist'obtarn a rreiv perr»if if there is a change ofd
resaig veriri+c4Me.A aerfcate rs rtscesary to document vrhytax is not collected on a sate. ownership, location, or business location name
i TAXPAYER NAME .�UStNESS LOCATION NAME, and PHYSICAL LOCATION Type of permit
BAYLOR.HEAtTH fNTERPRI.SES, L.P. SALES AND USE TAX
rY Taxpayer number
s BAYLOR F4ED 1 CAL P� AAA A GRAPEVINE 1-75-1997378-2
1600 `W COL1:'EGE $T: STE ;11Q on number
GRAPEVINE TX 76051 -3575 00029
TARRANT COUNTY'- fl }+stns ao o�
p 4
NAIC5 CODE X46110.. OESCR{
'^, -.
`Pharmacies and'Drug Stores° s <x a k }k r
WE SHOW THIS tiUSiN(<SS inl TNE'.FOLL0l1!ifdG
CITY' G
'APE'. :11 E' t'
pD 6RAPEVIN citIME COttiROL t!" tip C3 i 3w *, ax at v tU g a
x S �^.�'w' mti �, �, A� t l �.�� z . rW,�`.c'� �� ✓"+ t � iL1i1 ��y�'.�y1 �; .,; e 0 �„ Y1 r 'S �d ,?• �' 1 �'�'�"v'.
e a � +''"„��i„".� mt �� �'`s � } �✓Ya,�y r *" w�,� ^r �r�'7t1�'i#�i.y. � v<yy5�u'i;�y T ��i iky S`%;;� n"�?,4, .d „� �'.. t ,�".ka%�,
w�
You may need to collect sales andlor use tax for other local ta)ong authorities depending on your type of business.
For additional information, see 'Collecting Local Sales and Use Tax" section on the back of this document.
If you have any questions regarding sates tax, visit our website at www.window.stateAx.us or call us at 1 -800- 252 -5555 or 512- 463.4800.
Detach here and prominently display your permit only. Retain the portion below for your records. ar.suaN
Is the Information Printed on this Permit Correct?
The information printed on your permit is public information. It must be accurate and current. If there is
an error, snake corrections on the form below. Enter the correct information for incorrect items only.
Detach the form and mail it to:
Comptroller of Public Accounts
111 E. 17th Street
Austin, TX 787740100
More helpful information about your permit is on the back of this document.
Texas Sates and Use Tax Permit Corrections Form
Taxpayer name shown on the permit
BAYLOR HEALTH ENTERPRISES, L.P.
If you need to make changes to
your local sales tax authorities
Taxpayer number shown on the permit
Location number shown on the permit
17519973782
00029
or to the NAICS code printed
on your permit, see information
Correct business location name
•
on the back of this form.
Correct business location (no P.O. Box or directions accepted) .
e
City
a
State
ZIP code
County
Correct taxpayer name
e
Daytime phone Area code end number)
Correct mailing address
a
City
a
State
ZIP code
Federal Employer Identification Number
If you are no longer in business, enter the date of your last business transaction,
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sign Taxpayer of authorized agent
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