Loading...
HomeMy WebLinkAboutPLBG2023-002853ADDRESS 1802 Branch Hollow Ln. Grapevine, TX 76051 LEGAL Shadow Glen Addition Ph 2a & 2b Blk 12 Lot 6 A6 S220 12 *05840554* PERMIT HOLDER JOHN SCHRADER Schrader Plumbing (817) 495-3917 COLLABORATORS •JOHN SCHRADER Schrader Plumbing (817) 495-3917 OWNERS •O'Keefe, Thomas INSPECTIONS 4 1. Plumbing Water Service 2. TCEQ Backflow Certification Submit 3. Backflow Device Inspection 4. Plumbing Final INFORMATION FIELDS **APPLICANT NAME (Individual)Amanda Davis **APPLICANT PHONE NUMBER 817-262-0989 VALUATION 5000 FEE TOTAL PAID DUE Plumbing Permit Fee {VALUE}$ 72.00 $ 72.00 $ 72.00 TOTALS $ 72.00 $ 72.00 $ 0.00 READ AND SIGN 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. August 08, 2023 Signature Date City of Grapevine PO Box 95104 Grapevine, Texas 76099 817) 410-3166 Plumbing Permit {VALUE} Project # 23-002853 Project Description: replace double check, 60 ft water line replacement Issued on: 08/08/2023 at 5:23 PM MYGOV.US 23-002853, 08/08/2023 at 5:23 PM Issued by: Connie Cook Page 1/2 ,L� S: to .. , _..-..- — /./ticLoW Li✓ OVR-rAKYl WS CONTACT PERSON: uired by comrmssion regulations r ADDRESS OF SERVICE: ��� The backflow prevention assembly detailed below has been tested and maintained as req PA)' and is cerlifi�e io be o eratin tvithin acce table arameters. T e II ❑I - TYPE OF BACKFLOReduced d Red Pressure PtAn SPetectoB (12PBA-D) Ty Reduced Pressure Principle (RPBA) ❑ CVA-D) Type III❑I - - - - - - - - - Double Check -Detector (D ICI Double Check Valve (DCVA) ❑ I _ Spill -Resistant Pressure Vacuum Breaker (SVB) ❑I Pressure Vacuum Breaker (PVB) ❑ p t i Main: Bypass: �l - Size: /V�;Ei� - 1 - Main: BYPass: Manufacturer: © YP BPA Location: I oJ� Model Number: Main: 3 �Bypa s: BPA Serves: Serial Number: Mam:,i ---------- Replacement ❑ Old Model/Serial # I I No Reason for test: New Existing ❑ p Is the assembly installed in accordance with manufacturer recommendations and/or local codes? ❑ - ee ,lrOi�NO � Is the assembly installed on anon -potable water supply (auxiliary)? t�� - II TEST RESULT PASO [( FAI� ❑I i ial Test ate: W/�i7(23 Time: Tr25Ar.- Repairs and Materials Used** Test After Repair Date: I I Time: Reduced Pressure Principle Assembly (RPBA) DCVA Relief Valve 15L Check 2nd Check*** -----� � �� p Opened at Held at si eld at � Sid Op psid Closed Tight Closed Tight J Did not Leaked ❑ Leaked .I❑ open I❑I Main:1 Bypass: Held atL__j psid Held atL___j psid Opened at u Closed Tight I❑I Closed Tight I❑I psid *** 2'd check: numeric Type PVB & SVB Assembly -_ J_- Bypass Check Air Inlet Check Valve Held at sid Opened at psid Closed Tight �❑ I Did not open jbI Leaked ❑ Did it fully open (Yes I❑I, /No I01) Held atL_j psid Closed Tight I❑I for DCVA Differential pressure gauge used:/'ll 9 6-5T I Potable: i� I Mae/Model: J rd cf 55- 002A SN: ,ggao Remarks: it Company Name: Licensed Tester Name S kVt6-c5 (Print/Type): Company Address: Sk Qp��LW Licensed Tester Name (Signature): Ca k 3 TQ.A((- ompany Phone #: BPAT License # g7 - 722 — 2-9 0 ii License Expiration Date: The above is certified to be true at the time of testing. * TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS [30 TAC §290.46(B)l ** USE ONLY MANUFACTURER'S REPLACEMENT PARTS Opened at L_-j psid Held at psid Leaked I❑I Held at L---j psid a 11 Non -Potable: �❑� { Date tested for accurate la.'ec- �2 t (p