HomeMy WebLinkAboutPMISC2025-003158City of Grapevine
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PO Box 95104
Project 1
Grapevine, Texas 76099
817 410 3166
to the pool
Project Description: Add backflow device equipment "Shorewood Park Town Homes"
14101F
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Issued on: 08/13/2025 at 1:20 PM
ADDRESSINSPECTIONS
1924 Shorewood Dr.
Grapevine, TX 76051
1. TCEQ Backflow Certification Submit
3. Plumbing Final
2. Backflow Device Inspection
LEGAL
Shorewood Park Town
INFORMATION FIELDS
Homes Blk B Lot n/a
Shorewood Park Town
—APPLICANT NAME (individual)
Above and Beyond Plumbing Services
Homes All Units & 100%
—APPLICANT PHONE NUMBER
239-565-3618
Of Common Area
VALUATION
500
PERMIT HOLDER
Tanner Henshaw FF TOTAL A
Above and Beyond Plum Plumbing Miscellaneous Fee $ 37.00 $ 37.00 $ 37,00
Bing Services LLC
(469) 995-5069 TOTALS $ 37.00 $ 37.00 $ 0.00
COLLABORATORS READ AND SIGN
® Tanner Henshaw
Alcove and Beyond I HEREBY CERTIFY THAT THE FOREGOINGIS CORRECT TO THE BEST OF
MY KNOWLEDGE ALL K ILL F I T
Plumbing Services THE DOCUMENTSV Y THE BUILDINGDEPARTMENT AND 1
LLC COMPLIANCE WITH THE CITY OF GRAPEVINE CODES REGULATING
(469) 995-5069 CONSTRUCTION. IT IS UNDERSTOOD THAT THE ISSUANCE OF THIS PERMIT
DOES NOT GRANT OR AUTHORIZE ANY VIOLATION OF ANY CODE OR
OWNERS ORDINANCE OF THE CITY OF GRAPEVINE.
• Shorewood Associates I FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH
Lp ANY FEDERAL, STATE, AND / OR LOCAL LAW REGARDING ENERGY
CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE
Inez Medlock Sullivan LAWS, AND THAT VERIFICATION OF ENERGY CODE COMPLIANCE SHALL BE
• Shorewood SUBMITTED TO THE CITY UPON REQUEST.
Townhomes
imm
August 13, 2025
Date
MYGOV.US 25-003158, 08/13/2025 at 1:20 PM ISSUed by: Courtney Cogburn
Texas Commission on Environmental Quality
BACKFLOW PREVENTION ASSEMBLY TEST AND MAMENANCE REPORT
Thefblloorm must be coqKletedfoT each assembl% tested. A signed and dated original must be submitted to tbe:. ublic water su�ll,lier for rccordkc-v, in:! oses'.,
NAMEOFPWS: Gna i
PWS ib#:
220Q0 13,
PWS MAILING ADDRESS: 501 suo",
PWS CONTACT -_ PERSON: Backflow Coordinator
ADDRESS OF SERVICE:
The backilow prevention assembly detailed below has been tested and maintained as required by coninussion regulations
and is certified to be oatim_, within accept;ible parameters.
TYPE OF BACKFLOW PREVENTION ASSEMBLY (BPA):
P! Reduced Pressure Principle (RPBA) 0 Reduced Pressure Principle -Detector (RPBA-D) Type H 10
[jr Double Check Valve (DCVA) Double Check -Detector (DCVA-D) Type R
Pressure Vacuum Breaker (P`VB) w 0 Spill -Resistant Pressure Vacuum Breaker (SVB)
Manufacturer: Main: Bypass: I Size: Main:
Model Number: Main: Bypass�j 1 BPA Location:
Serial Number: Main: Bypass- i BPA Serves:
PERMIT NUMBER -
Old Model/Serial Reason for test: � New Existing EJ Replacement
Is the assembly installed in accordance with manufacturer recommendations and/or local codes?
Is the assembly installed on a non -potable water supply (auxiliary)?
Bypass:
El ;E11 No
X,Ves�JOJNo
TEST RESULT Type 11
Reduced Pressure Principle Assembly (RPBA) Assembly PVB & SVJ3
PAS91 01 DCVA
'Relief Valve Bypass Check Air Inlet Check Valve
Check
FAEL 13 1" Check 2m Check** 1�
5
IWdal Test 1,Held
at LL:�L peed Held at nWqld Opened at !Held at L psid Held at 1 psid Opened at,
t d
ate:�,Closed Tight 0 1 �iClosa Tight Ml! In psid
J Tight. :01 lClosed TIght ;E] Did not open lol I psi
13 Leaked
Time: i [
13,eaked Leaked �,.Did not icil U-caked Did it fully open
J!open
(Yes 01 /No 1111
Repairs and Main:'
Materials
Used "
ypass:
Test After Held at !PsidtHeldat___Jpsid qFOpenedat- �.Heldatl_lpsid! edat! usid Held at
Ppen
R ir Q D UI psid IClosed psid
�ea Closed Closed Tight
ID ITight ate in e
2111 check. numeric readim-1 re,juired for DCVA only
Differential pressure gauge used- Potable: Non -Potable:"
SN.
Mak&Model. Date tested for accurac
alar
Company Name: Licensed Tester Name
j"nt/T � jge)-
Company Address: t ice nsed Tester Name (Signature):
Company one W. BPAT License #
License Expiration Date:
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)]
** USE ONLY MANUFACTURER'S REPLACEMENT PARTS
TCEQ-20700 (Revision 04-04-2019) Page 1 of 1