HomeMy WebLinkAboutDEMO2011-40581
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NOV 0 2 2011 DATE OF ISSUANCE: d 1.6,�2 ./
PERMIT #: / b
\ \' // BUILDING PERMIT APPLICATION
PLEASE PRINT
JOB ADDRESS: 9 1 V 0V+111) A 1 y1 S� ' SUITE #
LOT: P, BLOCK: I SUBDIVISION: A10 � M 414 Wr
BUILDING CONTRACTOR (company name): LA VY1 IM 4h A A l^
(3 )
YQ Z k? 't YJ e "-t ON ( -
CURRENT MAILING ADDRESS: 3 C)
s �y ALl-
Setbacks
Approval to Issue
CITY /STATE /ZIP: GcwV,TI i'L ��
�p 0,S- , PH: # 2 - 117-5-0 lax #
Front:
Electrical
PROPERTY OWNER: W A K b
0- H jo(`(w O R-I
Left:
Plumbing
CURRENT MAILING ADDRESS: a7�
W E S &Vl ( J E UIV
Rear:
Mechanical
CITY /STATE /ZIP: �1 ✓LQOv� -ViC
OS- PHONE NUMBER:
PROJECT VALUE: $ 0 0 0
FIRE SPRINKLERED? YES
NO
Date: I (
DESCRIPTION OF WORK TO BE DONE:
A e5 pS W) 0 Vl1
Site Plan Approval:
Date:
USE OF BUILDING OR STRUCTURE: W, 4� YiGC A ti/G- I bT
ire Department:
NAME OF BUSINESS: W1 A- .
* *Total Square Footage under roof: -I/
6o ®v
Square Footage of alteration /addition:
❑ I hereby certify that plans have been reviewed and the building will be inspected by a certified energy code inspector in accordance with
State Law. Plan review and inspection documentation shall be made available to the Building Department (required for new buildings,
alterations and additions)
❑ I hereby certify that plans have been submitted to the Texas Department of Licensing and Regulation for Accessibility Review.
Control Number: (Not required for 1 & 2 family dwellings)
® / I hereby certify that an asbestos survey has been conducted for this structure in accordance with the regulatory requirements of the Texas
Department of Health.
(REQUIRED FOR DEMOLITIONS, ADDITIONS AND OR ALTERATION TO COMMERCIAL AND PUBLIC BUILDINGS)
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 Ordinance 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 FURTHERMORE UNDERSTAND
THAT PLANS AND SPECIFICATIONS ARE NOT REVIEWED FOR HANDICAPPED ACCESSIBILITY BY THE CITY, AND THAT THE
DESIGN PROFESSIONAL /OWNER IS RESPONSIBLE FOR OBTAINING SUCH APPROVAL FROM THE APPROPRIATE STATE AND
OR FEDERAL AGENCY(S).
PRINT NAME: W v A IA o• H-" 0 0141� SIGNATUR
PH #: ���' �%�� � C047 FAX #: 01%' 3�A- 6 D0� EMAIL: 13 'CHECK BOX IF PREFERRED TO BE CONTACTED BY E -MAIL C'D m
THE FOLLOWING IS TO BE COMPLETED BY THE BUILDING INSPECTION DEPARTMENT
Construction Type:
Permit Valuation: $ 315 CUNp
Setbacks
Approval to Issue
Occupancy Group:
Fire Sprinkler: YES NO
Front:
Electrical
Division:
Building Depth:
Left:
Plumbing
Zoning: O
Building Width:
Rear:
Mechanical
Occupancy Load:
Right:
Plan Review Approval:
Date: I (
Building Permit Fee:
Site Plan Approval:
Date:
Plan Review Fee:
ire Department:
Date:
Lot Drainage Fee:
Public Works Department:
Date:
Sewer Availability Rate:
Health Department:
Date:
Water Availability Rate:
Approved for Permit:
Date: if
Total Fees:
t�
Lot Drainage Submitted:
Approved:
Total Amount Due:
P.O. BOX 95104, GRAPEVINE, TX 76099 (817) 410 -3165
O:FORMSTSPERMITAPPLICATIONS 1/ 02- Rev.11104,5/06,2/07,11/09,4/11
I.,i
CITY OF GRAPEVINE
SK MECHANICAL ELECTRICAL PLUMBING FUEL GAS
PERMIT APPLICATION
(PI_FASF PRINTI
PERMIT# /1 f /�L
BLDG. PERMIT #
DATE:
JOB ADDRESS: L1 f SUITE #
J S_
DESCRIPTION OF WORK:
PROPERTY OWN R:
�
CONTRACTING 1:0 f� P Y:
C �
G L
AliJ
ADDRESS:
ADDRESS:
CITY /STATE /ZIP'
CITY /STATE /ZIP:
PHONE NUMBER:
PHONE NUMBER: 12z /7
` , ����
l
TYPE OF OCCUPANCY
BUILDING AREA
(SO FT)
PERMIT FEES
AMOUNT DUE
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
�(� a
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
3,001- 5,000
$ 72.00
CONTRACT VALUATION OF WORK:
5,001- 50,000
$ 27.00+.009
6_ . -
d
50,001- 100,000
$ 127.00+ .007 PER
1
$ ,
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*
• REINSPECTION FEES ................................................................................... ............................... $42.00
• PERMITS FOR WHICH NO FEE IS SPECIFICALLY INDICATED ............................ ............................... $37.00
• INSPECTIONS FOR WHICH NO FEE IS SPECIFICALLY INDICATED (1/2 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 / OR
LOCAL LAW REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS,
AND T �TION OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT PRINTED NAME
(OR HOMEOWNER FOR HOMEOWNERS PERMITS)
PHONE* /71? -77/1 70 D U EMAIL:
*OR THE TOTAL HOURLY COST TO THE JURISDICTION WHICHEVER IS GREATER.
* *ACTUAL COSTS INCLUDE ADMINISTRATIVE AND OVERHEAD COSTS.
CITY OF GRAPEVINE, BUILDING INSPECTIONS, P. O. BOX 95104, GRAPEVINE. TX 76099
6/21/01 REVISED: 10/01, 5/06,2/07,7/07,8/09,11/09,4/11
O: \FORMS \DS APPLICATIONS - FEES \MEP APPLICATION 4- 11 -doc
(817) 410 -3165
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.e2of9
April 8, 2009
Jeff Avery
K Avery Management
3063 Parr Lane
Grapevine, TX 76051
Re: Demolition Asbestos Survey
Former Nursing Home I House / Shop
408 -414 N Main
Grapevine, Texas 76051
EP Project #. EP -2959
Dear Sirs:
Per your request, Envirophase, Incorporated (EP) has performed a Demolition Asbestos Survey on the above
referenced location. The survey was conducted in accordance with the Texas Asbestos Health Protection Rules
(TAHPR) and the National Emission Standards for Hazardous Air Pollutants (NESHAP). The objective of the
Demolition Asbestos Survey was to identify the most apparent materials for sampling and analysis to determine
the presence or absence of asbestos - containing material (ACM). The survey consisted of noting observable
materials (materials that are readily accessible and visible in areas accessed by the inspector) which are
commonly known to potentially contain asbestos. The survey was intended to identify all sources of asbestos in
the property interior and exterior, which may be disturbed during the up- coming demolition. Additional sampling
may be warranted should the user's objectives change. The results herein cannot guarantee that asbestos is not
present in areas not sampled or areas concealed by physical barriers which restrict access.
Property Description
The subject property located at 408 -414 N Main, Grapevine, Texas consists of a single -story commercial building
formerly utilized as a nursing home. In addition a single family home along with a small building occupies an area
south of the main building. The total structural area is approximately 6,000 square feet. According to Jeff Avery,
building owner, all three structures are to be demolished. Interior of the buildings consist of painted and textured
drywall walls, textured ceilings, along with various flooring materials such as carpet, ceramic tile, and sheet vinyl.
The exteriors consist of brick veneer and wood. Roofing is comprised of composition shingles over plywood
decking,
Sampling Methodology
A visual inspection and sampling survey was conducted in accordance with current industry standards for a
limited asbestos survey to determine the presence of suspect ACM.
Mr. Scott Bass (TDH License # 602701), performed the asbestos sampling. An initial walk - through was
conducted to determine the presence of suspect materials that were accessible and /or exposed, Materials that
were similar in general appearance were grouped into homogeneous sampling areas.
Following the walk - through, the inspector - collected samples of all building materials defined as suspect
Asbestos - Containing Building Material (ACBM). Sampling locations were chosen to be representative of the
homogeneous sampling area.
Laboratory Methodology
Bulk samples obtained from the facility were analyzed in an independent National Voluntary Laboratory
Accreditation Program (NVLAP) laboratory using Polarized Light Microscopy (PLM) with dispersion staining
(Quantem Laboratories, 2033 Heritage Park Drive, Oklahoma City, OK 73120; NVAP #101959, TDH #30- 0143).
Samples were analyzed using Polarized Light Microscopy (PLM) (EPA 600/r- 93/116) with dispersion staining.
11105%
Page 1
The results of this analysis are summarized in the "Findings' portion of this section. Analysis was performed by
using the bulk sample for visual observation and slide preparation(s) for microscopic examination and
identification. The samples were mounted on slides and then analyzed for asbestos (chrysotile, amosite,
crocidolite, anthophyllite, and actinolite /tremolite, and fibrous non - asbestos constituents). Asbestos was
identified by refractive indices, morphology; color pleochroism, birefringence, and extinction characteristics. The
same characteristics were used to identify the non - asbestos constituents, The laboratory report and chain of
custody is attached to this letter.
Findings
A total of 108 samples were collected, representing 32 homogeneous areas. Of the 108 bulk samples analyzed,
24 of the samples tested positive ( >1% asbestos) for asbestos - containing materials. The following table
summarizes all of the materials which tested positive.
Materials Requirinq Abateinf --ni
Sample
Description
Location
Asbestos Content
Condition
1,2,3
Popcorn Ceiling Texture
Front Area of Main Building
4 tU C) `X) Chr °sofiki
Poor
7,8,9
Black Floor Tile Mastic
Area 4 Main"guilding
2 to 3
Poor
13,14,15
Leopard Sheet Vinyl
Halfway Main Building
")) yt, C III ;;> r;;
Poor
22,23,24
Tan Sheet Vinyl
Floor in Area 4
25 %, Chr Y olfflt,
Poor
25,26,27
Red Sheet Vinyl
Area 10 Restroom
20% CIIr sotile
Poor
28,29,30
Green Sheet Vinyl
Floor in Area 19
3r1 'o chrysotile
Poor
37,38,39
Popcorn Ceiling Texture
Rear Area of Main Building
Poor
85,86,87
Joint Compound
House at 408 N Main 1
2"% Chr Fotilr=
Poor
N/A
Transite Siding
30 Sq Ft Interior Closet I
Assunicd
Poor
A final point count was authorized to be performed on samples 37, 38, and 39 along with samples 85, 86, and 87,
All materials found to contain a quantity of greater than one - percent ( >1 %) asbestos content require abatement
by a licensed asbestos abatement contractor pursuant to the rules and regulations of the Texas Department of
State Health Services. The following table summarizes the findings of the point count analysis.
Point Count Results
Sample
Description
Point Count Results
37
1
Popcorn Ceiling Texture
1.50'1 Chr sotile
1
86
Joint Compound
1.25°!, Chr sotile
All of the materials listed in the above referenced tables will need to be quantified and will require abatement. A
copy of the Laboratory Reports are Appended.
It has been a pleasure to be of service to you. If you have any questions or comments, please do not hesitate to
contact Envirophase at (817) 266 -5143 or email at .
Sincerely,
ENVIROPHASE, INCORPORATED
ASBESTOS MANAGEMENT PLANNER AGENCY #200151
SCOTT BASS
FREDDA BENTON
Project Manager
Management Planner
TDH License #. 602701
TDH License # 205294
L_._
try �� alk M 0
a ,=
Wk%�rBXA R��S
2033 Hedta e Pats: Drivc I Oklabotn7 City. Dl{ 73120 1 (405) 755 -7272 ! Fax (405) 755 -2053
Envirophase, Inc.
1129 N. Fielder
Arlington, TX 7601'
Re: QuanTEM TD 171199
QuanTEM appreciates the opportunity to provide analytical testing servi= to you_ Attached are your reports and other
supporting documentation for the above referenced project.
Thank you for malting QuanTEM your lab of choice. if you have any question concerning this or other reports please feel
free to contact us at 800- 822 -1650.
We continually work to improve our service. Help us out by providing feed back on your experience at
ww6v.QuanTEM_eom. Click. on Service Survey and fill out the,form. We look forward to hearing from you.
Respectfully,
QuanTEM Laboratories, LLC.
^0 EL EM �1
%NN0
LABORATORIES
2033 Heritage Park Drive/ Oklahoma City, 0!f 73120 ! (405) 755-7272 f Fax (405) 755-20613
Polarized Light Microscopy Asbestos Analysis Report
QnauTEM Lab -,,?o.
171199
Client:
Envirophase, Inc.
Account Number:
B545
400 Point Count
1129 N. Fielder
002 39
Arlington, TX 76012
Date Received:
04/09/2009
Received By:
Barbara Holder
Date Analyzed:
04/10/2009
Project:
403 -414 North Main
Analyzed By:
Shelly Bromley
Project Location:
Grapevine, Texas
Methodology:
EPA/600/R- 93/116
Project Number:
EP -2959 Pt Ct for 171063
QuanTEM
Client
Color!
Non - Asbestos Non Fibrous
9"le 7D Sample ID Composition
Description. Asbestos ( %}
Fiber ( %)
001 37 Homogeneous white Asbestos Present Cellulose <1 CaCO3
UnIeSS otherwise noted, upon receipt the condition of the sample was acceptable lbr analysis.
QuanTEly£ is a NVUP aecmdhd TEM and PLlvi laboratory (Lab Cade: 101959 -0). This mport rLlatcs only to the specific items tested. NW AP accreditation applies
a,ily to analysis pezforrned utilizing EPMOMM -82 -020 and EP V600/R- 93/116 methods. This report may not be used to claim product endorsement byNVLAP or any
othcr agency of tlic US Governnreat. This -report may not be reproduced except in full, wiffiout the written approval of the laboratory,
Pagel of 2
Ceiling Texture
Chrysotile 1.5
Vermiculite
400 Point Count
Paint
002 39
Not Analyzed
Positive Stop
003 39
* t a
Not Analyzed
Positive Stop
004 85
* "
insufficient Quzalty
�r.
Insufficient Quantity
005 86
Homogeneous Cream
Asbestos Present
Cellulose <1 CaCO3
Joint Compound
Chrysotile 1.25
Paint
400 Point Count
006 87"
°
*
Not Analyzed
Positive Stop
UnIeSS otherwise noted, upon receipt the condition of the sample was acceptable lbr analysis.
QuanTEly£ is a NVUP aecmdhd TEM and PLlvi laboratory (Lab Cade: 101959 -0). This mport rLlatcs only to the specific items tested. NW AP accreditation applies
a,ily to analysis pezforrned utilizing EPMOMM -82 -020 and EP V600/R- 93/116 methods. This report may not be used to claim product endorsement byNVLAP or any
othcr agency of tlic US Governnreat. This -report may not be reproduced except in full, wiffiout the written approval of the laboratory,
Pagel of 2
QuanTEM Lab No.
Account ItTumber:
Date Received:
Recei -ved By:
Date Analyzed:
Analyzed By.,
Methodology:
civi
LABORATORIES
2033 Heritage Park Drive/ Oklahoma Clty, OK 731201(405) 755 -72721 Fax (406) 785 -2058
Polarized Light Microscorj Asbestos Analysis Report
171.199
5545
04/09/2009
Barbara Holder
04/1012009
Shelly Bromley
EPA/600/11- 93/116
QuauTEA! Client Color /
Sample M Sample ED Composition Description
Client: En;rirophase, Inc.
1129 N. Fielder
Arlington, TX 76012
Project. 408 -414 North Main.
Project Location: Grapevine, "Texas
Project Number: EP -2939 Pt Ct for 171063
Asbestos ( %)
4/1_0/2009
- -- - - - -S ileily rnley, A�,y _ -- "Date of Report
Non- Asbestos
Fiber
Non Fibrous
Unless otherwise noted, upon receipt the condition of the sample was acceptable for analysis,
QuanTEM is aNVLAP accredited TEid and PLA•I laboratory (Lab Code: 101959.0), This rcgort relates only to the specific items tested. NVLAP accreditation al;plics
only to analysis performed utilizing EPA /600A44 -82 -020 and EPA1600/R 93/116 methods, This report may not be used to claim product en dorsentent by NVLAP or any
other agency of the US Government. This report may stiot be reproduced except in full, without the written approval ofthe laboratory.
Page 2 of 2
Page 4
APPENDIX B
CERTIFICATIONS
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an 92112008 R)r the minw! update:
hispeding 'Buildings for ACO&I
W i 11-2009
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SCOPE OF ACCREDITATION TO ISONEC 17025 :2405
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Mr. John E. Barnett
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