HomeMy WebLinkAboutPLBG2024-003844ADDRESS
2127 Tanglewood Dr.
Grapevine, TX 76051
LEGAL
Oak Creek Estates Blk 1
Lot 22
A 22
S220 1
*01985698*
PERMIT HOLDER
Stephen Harris
Berkeys (PLBG)
(817) 481-5869
COLLABORATORS
•Stephen Harris
Berkeys (PLBG)
(817) 481-5869
OWNERS
•Jones, Donald Ray
INSPECTIONS 3
1. TCEQ Backflow Certification Submit
2. Backflow Device Inspection
3. Plumbing Final
INFORMATION FIELDS
**APPLICANT NAME (Individual)stephen harris
**APPLICANT PHONE NUMBER 8174815869
VALUATION 2000
FEE TOTAL PAID DUE
Plumbing Miscellaneous Fee $ 37.00 $ 37.00 $ 37.00
TOTALS $ 37.00 $ 37.00 $ 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.
October 21, 2024
Signature Date
City of Grapevine
PO Box 95104
Grapevine, Texas 76099
817) 410-3166
Plumbing Permit - MISC
Project # 24-003844
Project Description: replacing one double check valve
Issued on: 10/21/2024 at 9:29 AM
MYGOV.US 24-003844, 10/21/2024 at 9:29 AM Issued by: Courtney Cogburn
Page 1/2
Texas Commission on Environmental Quality
The Lollowin - fqlp Tu
I A(bIS2mL4eted for each assembh tested- A qi,med and dated orivinp] must be submitted to the ilublic water suReEier for recordkeep
NAME OFPWS: Grapevine
PWS ID#:
22=11
'PWS MAILING ADDRESS:
PWS CONTACT PERSON: j ��.u�u...� w..�-�Q1.,, a . y_, .. -
rack ow Coordinator
ADDRESS OF SERVICE: J SFD (Steve Anderson)/ 2127 Tar1glewood Dr, Grapevine, TX 76051
The backflow prevention assembly detailed below has been tested and maintained as required by commission regulations
and is certified Lobe MKa -__q Ling,witbi c�Sptabl _L !p_parameters.
TYPE OF BACKFLOW PREVENTION ASSEM:BLY (BPA):
Reduced Pressure Principle (RPBA) El Reduced Pressure Principle -Detector (RPBA-D) Type if 01
Double Check Valve (DCVA)
El Double Check -Detector (DCVA-D) Type ff 4:1
Pressure Vacuum Breaker (PVB) 1,0 Spill -Resistant Pressure Vacuum Breaker (SVB)
I I Manufacturer: Main: - Bypass! Size- Bypass: I
Model Number: Main- L'��0,0_ Bypass.l, Location Main
:
5 41
Serial Number: Main: Bypass,:
BP A Serves:L1
PERMIT NUMBER: 24-003844
Reason for test: 1 New -Existing El Replacement 101 Old Model/Serial #
is the assembly installed in accordance with manufacturer recommendations and/or local codes? es
1[3i No
Ls -p
he assembly installed on a non water supply (au xiliaryi)_?0 lvejprNo
10y
TEST RESULT Type II
Reduced Pressure Principle Assembly (RP]BA) Assembly PVB & SVB
PASSAI DCVA
FAIL i El I Check 211 Check*** Relief Valve Bypass Check Air.Inlet Check Valve
'id
p psid Opened at Initial Test Held at psid Hold atZ4 f Held at' psid Opened at psid Held at
Date: /0- -If Closed Tight Closed Tight 'n Did not op
I Tirne:'Pll� Closed Tight 01 psid ; en psid
Leaked Leaked Leaked r Did not ®IDid it fully open Leaked
open (Yes 10I /No !01)
Repairs and Maim,
Materials
Used** Bypass. i
Test After Held at' Dsid Held at psid, Opened Held at! psid Opened at L psid Held at,
R 'd Closed psid
—11'2'r. Closed Tight 0' Closed Tight 01 Ps'
Date- Tight
Time:
7
me..
*** 21 check: numeric readiMj�e�trpd_fbr DCVA only
1—biff'e"re,n--t-ia-,Ip-r--essure—gauge —use-d-:-—--— ----- - --
Potable: Non -Potable: Ef
Fake/Model. ,-MidSesk SN.-_ J 10211751 Date tested for accuracy 11-01-2023
Remarks:
Company Name: Licensed Tester Name
Accuracy Backflow
I Robert MacCloskey
(Print/Type):
Company Address-, Po Box 6832 Licensed Tester Name (Signature):
McKinney, TX 75071
Company Phone #: BPAT License It I BP0021622
1972-699-7156
License Expiration Date: 11-22-2025
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
TCEQ-20700 (Revision 04-04-2019) Page I of 1