HomeMy WebLinkAboutPLBG2023-003139ADDRESS
5211 Fairmount Dr.
Grapevine, TX 76051
LEGAL
Glade Landing Addition
Blk 4 Lot 5
*05824249*
PERMIT HOLDER
Matt Melsheimer
Matthews Plumbing LLC
(972) 261-8887
COLLABORATORS
•Matt Melsheimer
Matthews Plumbing
LLC
(972) 261-8887
OWNERS
•Cowan, Julius
INSPECTIONS 3
1. Plumbing Rough In
2. Plumbing Water Service
3. Plumbing Final
INFORMATION FIELDS
**APPLICANT NAME (Individual)Matt Melsheimer
**APPLICANT PHONE NUMBER 972-261-8887
VALUATION 1000
FEE TOTAL PAID DUE
Plumbing Permit Fee {VALUE}$ 45.00 $ 45.00 $ 45.00
TOTALS $ 45.00 $ 45.00 $ 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 29, 2023
Signature Date
City of Grapevine
PO Box 95104
Grapevine, Texas 76099
817) 410-3166
Plumbing Permit {VALUE}
Project # 23-003139
Project Description: Repair water leak in front yard
Issued on: 08/29/2023 at 5:30 PM
MYGOV.US 23-003139, 08/29/2023 at 5:30 PM Issued by: Connie Cook
Page 1/2
Texas Commission on Environmental Quality
WF�%J &mV,&7u_vCX_VXP_1
The follovvimz form must be co=leted for each assernbl,, tested. A si,:ned and dated on ainal must be submitted to the public water suHer for recordkee;-in *i un oses:
NA.ME OF PWS:
PWS ID#:
PWS MAILING ADDRESS:
PWS CONTACT PER§`6K-_
ADDRES,S OTSI* _110E:
The backflow prevention assembly detailed below has been tested and maintaihed as required by commission regulations
and is certified to be operating within acceptable liar stars.
TYPE OF BACOW PREVENTION ASSEMBLY (BPA):
-'ressure Principle -Detector (RPBA -D)
Reduced Pressure Principle (RPBA) -
Reduced 1 Type ll'E]::
Double Check Valve (DCVA) El: Double Check -Detector (DCVA-D) Type 11 El
I F1 Pressure Vacuum Breaker (PV9) Spil
l -Resistant Pressure Vacuum Breaker (SVB)
Manufacturer: Main: Bypass: Size: Main: Bypass:
Model Number: Main: ro o -7/11 1 Bypass:, BPA Location:
Serial Number: Main:,) e5) 7;Bypass., BPA Serves:
Existing Replacement _!�IdMode]/Serial# LAj,1C-ft16V4&-.
Reasonfortest: New _il�l t
I Is the assembly Installed in accordance with manufacturer recoqurnendations and/or local codes?
2''es 1 0 No
is the assembly installed on a non -potable water SUPPIV (auxiliary)? - ❑ Y e S L__i_N_1 0
TEST RESULT Type 11
Reduced Pressure Principle Assembly (RPBA) Assembly PVB & SVB
Is
PAII DCVA
Relief Valve Bypass Check Air Inlet Cjheck Valve
2" Check" FAIL El V Check : ;__1
Initial Test 11 _Hel� at .7, psi� �,,.,ld at psjd�_ 1", Opened at Held at psid Opened at psid., Held at
Date: psid Closed Ti-ht Did not open
Closed Tight Closed Tigh E] ��psjd
Leaked Ej Did it fully open ,Leaked ❑
Time: Leak Leaked ;'Dad not Leaked A open
Ves El /No EJ)
Repair's and Main:
Materials
Used** iBypass:
Test After Held at psid :Held atLLN psid ',Opened Heldat sid �Opened at psid Held at
p
Re jair Closed Tight El Closed Tight ❑ ��psid Closed 2_ psid
Date: ;;Tight El
Time:
. ....... '**, 2" check. numeric reading required for DCVA only
Differential pressure gauge used:
Potable: Non -Potable: El
Make SN- Date tested for accurac\ -L - -2-3--
�J,
Remark
s:
Company Name: Licensed Tester Name r A
A
dt'jc"e
e
CW1
IJ (Print/T�,pe):_, C_
Company Address: PC2 173 2�_7 Licensed Tester Name (Signature):
Company Phone BPAT License #2-
License Expiration Date:
Z11 --Z
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 MANTUFACTURER'S REPLACEMENT PARTS