HomeMy WebLinkAboutPLBG2024-002546ADDRESS
3572 Twelve Oaks Ln.
Grapevine, TX 76051
LEGAL
Carriage Glen Addition
Blk 1 Lot 6
A 6
S220 1
*06588018*
PERMIT HOLDER
Ron Tierney
Tierney Plumbing
(817) 251-9292
COLLABORATORS
•Ron Tierney
Tierney Plumbing
(817) 251-9292
OWNERS
•Hubbard Brad Alan
INSPECTIONS 14
1. Plumbing Rough In
2. Plumbing Sewer
3. Plumbing Shower Pan
4. Plumbing Top Out
5. Plumbing Tub Seal
6. Plumbing Water Service
7. Plumbing Gas Service
8. Plumbing P-Trap
9. Plumbing Temp Gas
10. TCEQ Backflow Certification Submit
11. Backflow Device Inspection
12. Plumbing Customer Sevice
Inspection
13. Plumbing Water Heater
14. Plumbing Final
INFORMATION FIELDS
**APPLICANT NAME (Individual)Ron Tierney
**APPLICANT PHONE NUMBER 8172519292
VALUATION 1725
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.
July 19, 2024
Signature Date
City of Grapevine
PO Box 95104
Grapevine, Texas 76099
817) 410-3166
Plumbing Permit {VALUE}
Project # 24-002546
Project Description: Replace double check valve at the curb to
irrigation
Issued on: 07/19/2024 at 10:50 AM
MYGOV.US 24-002546, 07/19/2024 at 10:50 AM Issued by: Courtney Cogburn
Page 1/2
Texas Commission on Environmental Quality
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
The followin - fbrm must be com, leted for ewh assembh'tested. A signed nd dated orkirad must be submitted to the u wata supjAjer for recordkeel4n, W1:10SM
plic
i NAME OF PWS: Grapevine
f,WS ID#:
zz=:i
PIWS- MXIINGADDRESS:
PWS CONTACT PERSON: 13aq"oW tor
ADDRESS OF SERVICE,
SFD/ 3572 Twelve Oaks Ln
The backflow prevention assembly detailed below has been tested and maintained as required by commission regulations
and is certified to be oble parameters.
OF BACIUWW PREVENTION ASSEMBLY (BPA�:
Reduced Pressure Principle (RPBA) Reduced Pressure PrinFiple-Detector (RPBA-D) Type ]g �[31
srt
Double Check Valve (DCVA)
Double Cbeck-Detector (DCVA-D) Type H ID
jo j Spill -Resistant Pressure Vacuum Breaker (SVB) Pressure Vacuum Breaker (PVB)
Mani main: Bypass:; Size: 1"n: Bypass:
Model Number: Main- Bypass BPA Location:
i Main: 77
S�al. Numbe ass i BPA Serves-
Byp
PERMIT NumBER: 24-002546
Reason for test: i New JX' Existing -0' Replacement Old Model/Serial #I
Is the assembly installed in accordance with manufacturer recommendations and/or local codes 14 IYes No
Is the assembly installed on a non -potable water supply (auxiliary)?
, 0 1�'es j[Z No
TEST RMJMT:� Type 19
Reduced Pressure Principle Assembly (RPBA) Assembly PVB & SVB
PAS� DCVA
Relief Valve Bypass Check Air Inlet Check �Valve
I a Ch��k 2nd Chec�***
FAIL 0
psid 11 Held at 'i
Ipsid
Leaked
p,WTHeld at
21 check. numeric reading, re atured for pgApniv
Potable:
_D�R;;n�ai pressure gauge used: Nop-Potable:
SN: 111306 61-02- 41
MakelModel: Ljq 31 Date tested for pnMac,�
Remwks-
Company Name: Licensed Tester Name
.01 Accuracy Backfiow Brian Cox
(PrintlType),
Company Address: Po Box 6832 Licensed Tester Name (Signature):
McKinney, TX 75071
Company one It. I SPAT License # BPDI�T77066-
972-699-7156
License Exg,iration Date: 02-23-25
The above is cerdfied to be true at the thne of tesfin&
TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS [30 TAC §290.46(B)j
** USE ONLY MANUFACTURER'S REPLACEMENT PARTS
TCEQ-20700 (Revision 04-04-2019) Page I of 1