HomeMy WebLinkAboutPLBG2023-002916ADDRESS
5230 Heatherdale Dr.
Grapevine, TX 76051
LEGAL
Shadow Glen Addition
Ph 2a & 2b Blk 4 Lot 7
A7
S220 4
9/9/19, PER TAD - 1,997
SQ FT
PERMIT HOLDER
David Butler
Milestone Plumbing
(972) 526-5926
COLLABORATORS
•David Butler
Milestone Plumbing
(972) 526-5926
OWNERS
•Wood, Rex W
INSPECTIONS 1
1. Plumbing Final
INFORMATION FIELDS
**APPLICANT NAME (Individual)Shanna Nevil
**APPLICANT PHONE NUMBER 9725265926
VALUATION 8232
Square Footage 1
FEE TOTAL PAID DUE
Plumbing Permit Fee {VALUE}$ 101.09 $ 101.09 $ 101.09
TOTALS $ 101.09 $ 101.09 $ 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 21, 2023
Signature Date
City of Grapevine
PO Box 95104
Grapevine, Texas 76099
817) 410-3166
Plumbing Permit {VALUE}
Project # 23-002916
Project Description: Replacing yard water service and double
check
Issued on: 08/21/2023 at 12:09 PM
MYGOV.US 23-002916, 08/21/2023 at 12:09 PM Issued by: Connie Cook
Page 1/2
Texas Commission on Environmental Quality
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
The follo-I form mu-1 be coin leticid fear each assernbky%eswd. As! lined and dated on iimal ril W submitted to tine public kvatergui, Her for lecordkee,!" U;, cli
NAME OF PWS: Grar)evine, TX
PWS ID4:
PWS MAILING ADDRESS: 200 S Main Street Grapevine, TX, T6051
PWS CONTACT PERSON: Permits
ADDRESS OF SERVICE: Rex Wood 5230 Heat herdale Dr Grapevine, TX 76051
The back ow prevention assembly detailed below has been tested and maintained as required by commission regulations
and is certified to be olh.,rating within acceptable parameters.
TYPE OF BACKFLOW PREVENTION ASSEMBLY (BPA)-.
Reduced Pressure Principle (RPBA) Pressure Principle -Detector (RPBA-D) Type 11 El
Double Check Valve (DCVA) D Double Check -Detector (DCVA-D) Tyre tt
E] Pressure Vacuum Breaker (PVB) Spill -Resistant Pressure Vacuum Breaker (SVB)
Manufacturer: Maili:Watts Bypass: Size: Main: 3/4" Bypass:
Model Number: Main;LF007M3QT BMSS. BPA Location: Parkway at meter
Serial Number: Main:214000 Bypass- BPA Serves: Irrigation
Reason for test: New El Existing Replacement IZI Old Model/Serial # Unk Unk
Is the assembly installed in accordance with manufacturer recommendations and/or local codes? IZI Yes No
Is the assembly installed on a non -potable water supply (auxiliary)? El Yes El No
TEST RESULT Type 11
'Reduced Pressure Principle Assembly (RPBA) Assembly PVB & SVB
PASS 0 DCVA
Relief Valve Bypass Check Air Inlet Check Valve
FAIL 0 1-11 Check 2`1 Check**
Initial eat Held at 2.0 PsidJIeldat2.0 psid Opened at si&�Opened at
Meld at p paid Meld at
paid Date: 08-23-23 Clowd Tight Closed Tight 191 `1 Closed Tight E] ::Did not open i:psid
L_ "Did not El j�
Tirne: 3:20 PM :� E] Did it fully open Leaked
FLeaked Leaked Ulaked
open El
(Yes El /No El
Repairs and Main:
Materials
Used" Bypass:
. ....... . .
Test After Held at psid Held at psi d Meldat psid, Held at
'Opened at psi&: Opened at
�R le a �ir Tight ElClosedTight I—] �'psid lClosed psid
Date: ¢ jight
J
Time:
check: numeric readin:', required for DCVA onE
Differential pressure gauge used: Potable: 121 Non -Potable: 0
MakelModel: idwest 845-5 SN: 1!08132518 Date tested for accuracy : ,05-02-2023
Company Name: !4-Real Testing Licensed Tester Name
(Print/T,l lie): Marc 13;rr y
Company Address: �,9904 Sunrise Cv Licensed Tester Name (Signature):
.Oak Point, TX 75068
Company Phone #: 1-5 7-1 B PAT License # iBPOO19735
License Expiration Date: 106-24-26
The above Is certified to be true at the time of testing.
TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS 130 TAC §290.46(B)l
** USE ONLY MANUFACTURER'S REPLACEMENT PARTS
TCEQ-20700 (Revision 04-04-2019) Page I of I