HomeMy WebLinkAboutPLBG2013-2132JU�I. 3 2013
-�� CITY OF GRAPEVINE
A 6 MECHANICAL ELECTRICAL PLUMBING FUEL GAS
II ICI ,��� PERMIT APPLICATION
•� (PLEASE PRINT) JUN 21 201
PERMIT # J ,�
BLDG. PERMIT #
DATE: b L 1131 /,
JB ADDRESS: 1410 c ) Yz- , SUITE #
DESCRIPTION OF WORK:
t3s 71n ZA 7/
PROPERTY OWNER: i
CONTRACTING COMPANY:
ADDRESS:
ADDRESS:
:35/6 ( `) d e L ' 1r
CITY /STATE /ZIP:
CITY /STATE /ZIP:
W T
PHONE NUMBER:
PHONE NUMBER:
�r
TYPE OF OCCUPANCY
BUILDING AREA
(SQ 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
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
r—
50,001- 100,000
$ 127.00+ .007 PER
TVALUATION
7 )L
$ J %?%
100,001- 500,000
500,001+
$ 327.00+ .005 DOLLAR
$ 1,327.00+.003
$
EACH TRADE
V. MISCELLANEOUS
IRRIGATION SYSTEMS
$C'37.60
MOBfLE-HHIC7IE 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 (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 / 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.
� G
SIi NATURE OF'CONTRACTOR bR 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 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
CITY OF GRAPEVINE PWS ID# 2200013
WATER CUSTOMER SERVICE INSPECTION CERTIFICATION
DATE: 7 BUILDING
I
LN
SWIMMING POOL
ADDRESS:
` IRRIGATION
C p PERMIT #: G (v 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 Vill, (Ordinance number 92 -17), and Chapter
7, Article V, (Ordinance number 01 -93).
In addition, to the best of my knowledge, no cross connection exists at this address at the time of inspection.
SIGNATURE PECTOR III; ;ENU M
az 4-5 '.)
TITLE INSPECTOR
DATE
JUl 12013
CITY OF GRAPEVINE
r BACKROW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
NAME OF PWS: GRAPEVINE ANNUAL TEST
IRRIGATION ✓
PWS I.D.# 2200013 OTHER
NAME OF BUSINESS WHERE DEVICE IS'-yLO TED:
ll11
ADDRESS OF SITE SERVICED: T , r�C C
PLUMBING PERMIT IF APPLICABLE: # /'Z- _ J,: -:
A / J.
TESTER LICENSE NUMBER: EXPIRES: -/4
14
DATE OF LAST TEST GAUGE CALIBRATION: THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY
TCEQ REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS.
TYPE OF ASSEMBLY
REDUCED PRESSURE PRINCIPLE PRESSURE VACUUM BREAKER
�PDOUBLECHECK ATMOSPHERE VACUUM BREAKER
MANUFACTURER: D SIZE: 11 _
MODEL:. L SERIOL NUMBER: �--�
PHYSICAL LOCATION OF METER:
TESTERS FIRM NAME:
ADDRESS: -1
DATE:
PRINT NAME:
DOUBLE CHECK VA_ _
0,.V:C M51O3 REGISTRATION FORMSITCEO BACKFLOW TESTER REOISTRATION40C
1 VBIOOIRev. 4105, 1108, ?NO
REDUCED PRESSURE PRINCIPLE ASSEMBLY
PRESSURE VACUUM BREAKER
DOUBLE CHECK
VALVE
AIR INLET
CHECK VALVE
ASSEMBLY
RELIEF VALVE
1sT CHECK
2ND CHECK
Open at psid
psid
DC- Closed Tight
Closed Tight
Opened at
Initial
RP Z-9 psid
Did not open
Leaked
Test
4
Leaked
�:W�
Leaked
psid
Repair
Materials
Used
Test
DC- Closed Tight
Opened at
Opened at
After
Closed Tight
psid
Repair
RP psid
psid
= psid
TESTERS FIRM NAME:
ADDRESS: -1
DATE:
PRINT NAME:
DOUBLE CHECK VA_ _
0,.V:C M51O3 REGISTRATION FORMSITCEO BACKFLOW TESTER REOISTRATION40C
1 VBIOOIRev. 4105, 1108, ?NO