HomeMy WebLinkAboutPLBG2024-001168ADDRESS
804 Portamerica # B Pl.
Grapevine, TX 76051
LEGAL
D F W Ind Park Phase I
Addition Lot B3
S
PERMIT HOLDER
Bryan Barnes
All Masters Plumbing
(817) 969-5050
COLLABORATORS
•Bryan Barnes
All Masters Plumbing
(817) 969-5050
OWNERS
•804 Port America
Place Llc
TENANTS
•Shell Building / CCT
Plastics
INSPECTIONS 2
1. Plumbing Water Service 2. Plumbing Final
INFORMATION FIELDS
**APPLICANT NAME (Individual)Bryan Barnes
**APPLICANT PHONE NUMBER 8172004703
VALUATION 3000
Square Footage 100
FEE TOTAL PAID DUE
Plumbing Permit Fee {VALUE}$ 57.00 $ 57.00 $ 57.00
TOTALS $ 57.00 $ 57.00 $ 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.
April 03, 2024
Signature Date
City of Grapevine
PO Box 95104
Grapevine, Texas 76099
817) 410-3166
Plumbing Permit {VALUE}
Project # 24-001168
Project Description: WATER LINE REPLACEMENT
Issued on: 04/03/2024 at 5:29 PM
MYGOV.US 24-001168, 04/03/2024 at 5:29 PM Issued by: Connie Cook
Page 1/2
The following form must be completed for each assembly tested. A signed and dated original must be suhTi
NAME OF PWS: 0-(� (Irc.
WkLe_
PWS TD#: fDoo G
PWS MAILING ADDRESS: 50k Sy,,jal% art>ok, C>rifo 6 0"r-'e "a 7(00'51
PWS CONTACT PERSON: s arm rc,4_v-
-7 ke 0
ADDRESS OF SERVICE: 5*4 ?,X4- Ame'rC4 e�_
The backflow prevention assembly detailed below has been tested and maintained as required by commission regulations
and is certified to be operating within acceptable parameters. .. .. .. .....
Reduced Pressure Principle -Detector (RPBA-D) e Typ,
TYPE OF BACKFLOW PREVENTION ASSEMBLY (PYA
Reduced Pressure Principle (RPBA) IT
Double Check Valve (DCVA) Double Check -Detector (DCVA-D) Type 11
Pressure Vacuum Breaker (PVB) Spill -Resistant Pressure Vacuum Breaker (SVB)
Manufacturer Main: 7,1,4+5 Bypass:,. Size:- _Main:�: Bypass: t
ModelICI umber: Main: 'I.poo�jM,3 Bypass:': BPA Location: b, L, /air
Serial 1, Main:-1'19 Bypass:, , BPA Serves:
Reason for test: I New Existing Replacement i ?ld Model/Serial #
Is the assembly installed in accordance with manufacturer recommendations and/or local codes?
Is the assembly installed on a non -potable water supply (auxiliary)?
Type R
TEST RESULT ore Principle embly (RPBA) Assembly7l
[Reduced Press Ass
PASS I DCVA
W��
' 1 Relief Valve Bypass Check Air Inlet
F IL, �
A Ist Check 2-11 Check***
Test Held at �1 -A psid Held at,�- psid Opened at 2- IQ
-Z5-,Nf Closed Tight Closed Tight psid
Did not
00 A&, Leaked Leaked .0
open El
... ..............
"S and Main -
at psid Opened at psid
d Tight 0: Did not opIII en 40
-d
rl Did it fully open
(yes, El,
a-
Used""" j Bypass:
Held at psid Opened at psid Held at
T4;t �After�� Held at psid Held at psid, Opened at,
Re
psid Closed Tight Closed Tight psid
Close
lair d
Date: Tight 0!
Time:
2111 check: numeric reading required for DCVA on
it&r Ztial pressure gauge useth- Potable: Non -Potable: 'El'
Make/Model: mx
i, -S" Date tested for accuracy
Remarks:
Company Name: r Licensed Tester Name
(Printrrype):
C
Licensed Tester Name (Signature): ompany Address:
F-inji I
Company Phone BPAT License #
License Expiration Date:
The above is certified to be true at the thne of testing.
TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS [30 TAC §290.46(B)l
USE ONLY IAA NUFACTUREWS REPLACEMENT PARTS
1% =.-