HomeMy WebLinkAboutPLIRR2013-1611n CITY OF GRAPEVINE
MECHANICAL ELECTRICAL PLUMBING" FUEL GAS
PERMIT APPLICATION
(PLEASE PRINT)
PERMIT #
BLDG. PERMIT #
DATE: -
JOB ADDRESS:
SUITE #
DESCRIPTION OF WORK:
PROPERTY OWNER: i
CONTRACTING COMPANY:
ADDRESS:
.�r
ADDRESS:
CITY /STATEIZIP: �_
CITYISTATE/ZIP: r�+� 76021 1
G
PHONE NUMBER: q 7
PHONE NUMBER: 317*91IN-1t0V
TYPE OF OCCUPANCY
BUI `DIGNG AREA
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, 1, 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+
$ 58Z00+.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
50,001 - 100,000
$ 127.00+.007 PER
$
100,001- 500,000
500,001+
$ 327.00+ .005 DOLLAR
$ 1,327.00+ _003 TVALUATION
$
EACH TRADE
V. MISCELLANEOUS
IRRIGATION SYSTEMS
MOBILE HOME SERVICE
$ 3
TEMPORARY POLE SERVICE
$ 37.00
SWIMMING POOLS
$ 37.00
�. C'k
SIGN ELECTRIC
$ 37.00
$
OAFORMSMS APPLICATIONS - FEESWEP 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) .......................................... .x.....$42.00 /HOUR*
• REINSPECTION FEES---------------------------------------------------------- ------------------------- - - - - -- ........... .. $42.00
• PERMITS FOR WHICH NO FEE IS SPECIFICALLY INDICATED ................................ ..........:.'.F..,: -a .... $37.00
• INSPECTIONS FOR WHICH NO FEE IS SPECIFICALLY INDICATED (1/2 HOUR MINIMUM) ...........
°`�,r :.$42.00/FiOUR
• ADDITIONAL PLAN REVIEW REQUIRED BY CHANGES, ADDITIONS, OR REVISIONS TO
APPROVED PLANS ...................................... ......... ......... .......... . .. ...... ......... ........ ........ ... . .. .........$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 THAJVERIqICATI ON OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST.
�� j�/ ---7 1
lam' Ili
SIGNATURE OF CONTRALTO OR AUTHORIZED AGENT PRINTED NAME
(OR HOMEOWNER FOR HOMEOWNERS PERMITS)
*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 (817) 410 -3165
6/21/01 REVISED_ 10101, 5/06.2/07.711)7.8108. 11109.4/11
O:IFORMSOS APPLICATIONS - FEES%MEP APPLICATION 4.11.doc
JUN 10 2.013
CITY OF GRAPEVINE
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
NAME OF PWS: GRAPEVINE ANNUAL TEST
IRRIGATION
PWS I.D.# 2200013 OTHER
NAME OF BUSINESS WHERE DEVICE IS LOCATED:
ADDRESS OF SITE SERVICED: 1 a 9 " \ .P y-
PLUMBING PERMIT IF APPLICABLE: # t 3 — 14
TESTER LICENSE NUMBER: 6VQ0o0bgL
DATE OF LAST TEST GAUGE CALIBRATION:
EXPIRES: I' `I — IU
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
V?eDOUBLE CHECK ATMOSPHERE VACUUM BREAKER
MANUFACTURER:
MODEL: SERIAL NUMBER:
PHYSICAL LOCATION OF METER:
The above is certified to be true.
TESTERS FIRM NAME:
ADDRESS: + CITY /STATE/ZIPQ jjL), -6
DATE: 1 PHONE NUMBER:
PRINT NAME: I& nAP 11 AL SIGNATURE:
DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT (8171410-3010
C :I000UME- 11s0atlelLOCALS- 11TempWgMwee1TCEO BACKFLOW TESTER REGISTRATION.6m
11l3I00/R- WDS, 1/06.7110 .
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 -Close Tight
Closed Ti ht
I li `j
_RP psid
/ G�
L � l
Opened at
Did not open
Leaked
st
psid
Leaked
Leaked
Repair
Materials
Used
Test
DC- Closed Tight
Opened at
Opened at
After
Closed Tight
psid
Repair
RP _ psid
psid
psid
The above is certified to be true.
TESTERS FIRM NAME:
ADDRESS: + CITY /STATE/ZIPQ jjL), -6
DATE: 1 PHONE NUMBER:
PRINT NAME: I& nAP 11 AL SIGNATURE:
DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT (8171410-3010
C :I000UME- 11s0atlelLOCALS- 11TempWgMwee1TCEO BACKFLOW TESTER REGISTRATION.6m
11l3I00/R- WDS, 1/06.7110 .
JUN 10
BPM
S.bdc..¢rrr
O
INC.
SPRINKLER SYSTEMS & LANDSCAPING
f f 1901 -A Bedford Rd. • Bedford, TX 76021 - 817.540 -1559
www.m1dc1Uesirrigation.com
July 28, 2011
City of Grapevine
This irrigation system has been installed in accordance with all applicable State and Local laws,
ordinances, rules, regulations and orders. I have tested the system and determined that it has
been installed according to the irrigation plan and is properly adjusted for the most efficient
application of water at this time.
*THREE -YEAR WARRANTY ON COMPLETE SPRINKLER SYSTEM,
COVERING DEFECTIVE PARTS AND WORKMANSHIP
Irrigation in Texas is regulated by the Texas Commission on Environmental Quality
(TCEQ), MC -178, P.O. Box 13087, Austin; Texas 78711 -3087, TCEQ's website is:
www.tceq.state.tx.us
Darrell Bishop
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CITY OF GRAFf
. 2NS
RELEASE D-FOR
CONSTRUCTION
.4
15
FIA
SHEET: OF
.�'F DOES NOT AUTHORIZE ANY' WORK IN CONFLICT -E BUILDING CCDE OR ZONING ORDINANM
THIS PLAN TO B 'KEPT ON
ONTRACT01
THE JOB AT AL TIMES -11
va
_;A1 E:.-... !�_- T 2-0 13 BY- 114SPECTIONS•
BUILDING INSPECTION DIVISION
RELEASE DOES NOT APPLY T( %STRUCTION N
__EMENTS OR ON PUBLIC� % T OF-WAY.
i�LL CHANGES MUST,mr? PROVED
I.
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L
Irrigation s�j► m design and ln#altcMon shah comply with
all state and Ibcal laws and rules, including but not limited
S CA to the plumbing and residential codes adopted by the t3 to
City of Gropovine, H8 1656 pa,"(fty the State of Texas,
Ppe)1,4-ooc landscape irrigation rules cl&eloped by Texas
50, pmmiWn on Environmental, Qtxft (TCEQ), and Q'�
s6qypht amendments_ti� these laws and ruies.
RAIN AND FREEZE sensors are required. Backflow
prevention devices shall be tested by an approved agency,
i Ir.
on forms pro ded by the city. Completed forms verifying
proper op6 tion of device shall be returned to the city.
0
t
Failure to ob In final Inspection of Irrigation system shall
r 'I
tat f asult In sos nsion of contractoft registration and may
f c
w Le� result in loss gistration and / or the issuance of cltafion(s
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