HomeMy WebLinkAboutCO2025-003608UNDER CONSTRUCTION
TD — NO LETTER
STLTTER
PW OR LD NEEDED
PENDING FIRE'' 71
bIN`G HEALTH
LANDSCAPING / CODE
HOLD FILE
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C/O PERMIT#2
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ADDRESS:
BUSINESS NAME:
m
BUSINESS°°J PROPERTY
/ OWNER NEW CONST /ADDITION PERMIT#,,_,__,,,,--,
NEWtENANV OCCUPANT REMODEL/ L TI
ISSUE DATE �. ....,...... FINAL DATE
APPLICATION FORM COMPLETED
2. OKORDER FORM COMPLETED
ENVIRONMENTAL NOTIFIED DATE TIME
(E-MAIL JIMMY BROGK krr ftC s:r I ��rs �.d r s & VALERIE FARRELL w ry IB pevi Ietpx3q.( }
4. HAZARDOUS MATERIAL SAFETY DATA SHEETS TO FIRE DATE
(SCAN TO C/O IN MYGOV — IF LARGE SET, ALSO SCAN TO LF & FORWARD SET TO FIRE)
5. FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATE
6 ZONING CHECKED & COMPLETED ON APPLICATION
7. BUILDING INSPECTION SCHEDULED DATE TIME
8. FIRE DEPT INSPECTION SCHEDULED DAT E TIME
FIRE INSPECTOR:
9. HEALTH INSPECTION NOTIFICATION DATE: ,.
10. CITY SECRETARY (ALCOHOL) OTIFICATIOAT...._
11. PUBLIC WORKS INSPECTION E-MAIL DATE
12. LOT DRAINAGE INSPECTION E-MAIL DATE
13, CORRECTION LETTER SENT DATE
14. BUILDING INSPECTORS SIGN OFF LETTER: YES / NO
15. FIRE DEPARTMENTS SIGN OFF LETTER: YES / NO
16. HEALTH DEPARTMENT SIGN OFF
17. CITY SECRETARY (Alcohol License Sign O
18. PUBLIC WORKS SIGN OFF
19. LOT DRAINAGE SIGN OFF
20. LANDSCAPING SIGN OFF
21. BUILDING OFFICIALS SIGNATURE
22. C/O CERTIFICATE ISSUED
ELECTRIC RELEASED:_ ......... ....._._.._........_._.
SCAN CERTIFICATE TO MYGOV
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",�';°91 :�.��. "a.•,,,s .'� �A. � �""��" ff �.; .'� ff7 8 MAILED.
C.1F 0RMS\DSCOINF0RMAI IONIC KLIS f
121301041 Rev 5123/24
DATE OF ISSUANCE:
PERMIT
4"ERF'"IFI"'ATE OF OCCUPANCY "E"Ir UEST
FEE: $50.00
NO FEE REQUIRED IF THE CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITH AN ACTIVE CURRENT BUILDING PERMIT
/O
ADDRESS OF OCCUPANCY: /44 At Y�( SUITE#
LOT: BLOCK: SUBDIVISION: Hctaod _' camo7e dd
****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTIONIJ
NAME OF BUSINESS:
NEW OCCUPANT: YES NO NEW B'UILDING/Pk0PERTVOWNER: YES NO
NEW BUILDING: YES NO NEW BUSINESS NAME CHANGE: YES NO
NUMBER OF EMPLOYEES: NEW BUSINESS OWNER: YES' NO
FREIGHT F"PWARDING: YES NO _X
TYPE OF BUSINESS: C
Rehifl Clolhing /Awwne%'s Offiee f �Rvswunmt i ofnceAy.,. ei, use,t
W
**IF OFFICEfWARE HOUSE PROVIDE BR AK N OF SQUARE FOOTAGES:
SF OFFICE: /150 SF WAREHOUSE: 7 TOTAL SQUARE FOOTAGE:
_X
NAME OF TENANT 1PERSON'S -NMOEI: Arl lfvij RVAr-1,4.1
CURRENT MAILING ADDRESS: IAI 5 7-
CITY/STATE/ZIP: PHONE NUMBER: Mew, '� N 1 5_10 — 7719
PROPERTY OWNER:
F05�5
0 Prle4
4-,vl_'
/c in; L1
MAILING ADDRESS:
5,4e_
26o
CITY/STATE/ZIP: 75� -76os-1
PHONE NUNIBER:' R17
* IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if ves, provide copyof Sales Tax Certificate) -------
YES
1'40
+ WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes, provide copy of Alcoholic Beverage Permit) ---
YES
NO
* WILL THERE BE FOOD SALES? (if yes, contact Tarrant County Health 817-321-4983 for more information)
+ PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? ---------------------
YES
NO
4 WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? --------
YES
NO
# WILL OUTSIDE REFUSEiRECYCLINGiCOi'viPACTING CONTAINERS BE NECESSARYI(screening isrequired)
YE S
NO
WILL THERE BE ANY OUTSIDE STORAGE (including storage of company/fleet vehicles), DISPLAY/ USEIDINING? YES
NO _17
WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? ----------------------------
YES
NO )(
IS BUILDING SPRINKLERED? ----------------------------------------------------------
YESX W--
WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS?
(if yes, provide list of types & quantities, along with material safety data sheets) -------------------------
YES —
NO
I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF MY KNOWLEDGE AND THE SAID
OCCUPANCY IS IN CONFORMANCE WITH THE INFORMATION HEREIN SET FORTH.
(If access to the building/space is not provided at the time of the scheduled inspection, a 'x50.00 re -inspection fee will be charged)
FOR QUESTIONS or to, RE -SC I 11% DULE, PLEASE CALL (817) 410-3165 or (817) 410-3166
SIGNATURE:
PRINTNAME: /4/5
4.
�7
4�e irc,
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099
(817) 410-3165 * (817) 410-3166
Www.,.)ra,',:evinetexas.ov (OV ER)
C:FOP MSIR�PUCATIONrFEEM0 APP - j
"Ql-
TEXAS SALES TAX
Texas Sales Tax is charged and collected on sales within the State and City of Grapevine, Texas of "taxable items." Taxable
items include both tangible personal property, specified services. If you are in a business that will be selling "taxable items"
within the City of Grapevine, Texas you will be required to collect State and Local Sales Tax in the amount of 8.25 %.
A "Seller or Retailer" means a person engaged in the business of making sales of "taxable items", the receipts from which are
included in the measure of sales or use tax.
The term, "place of business" includes any location at which three or more orders are received by the "Seller or Retailer
in a calendar year. If an order is received at the place of business of a retailer in Texas, but delivery or shipment is made
from a location within the state other than the retailer's place of business. State and local sales tax is due and is allocated to
the city where the order was received.
I have read the above and I understand that I will be required to provide a copy of the Sales Tax Permit to the City of
Grapevine, Texas if the circumstance applies to my business.
Texas Sales Tax Number:
Signature:
WHERE DO YOU WANT YOUR.COTMPLETED CERTIFICATE OF, Q-CK,UPANCY A111AILED?
ADDRESS:—/5,-27- V/ 51.Ae- -d-,Sz�v —//z
CITY, STATE, ZIP: cis-/
OFFICE USE
TYPE OF CONSTRUCTION:_017 OCCUPANCY: DIVISION:
ZONING DISTRICT: CONDITIONAL USE: 141 Q
PERMITTED USE:, ...... OCCUPANT LOAD:
5/a 41 a
BUILDING DEPARTMENT: DATE:
ZONING APPROVAL:
FIRE DEPARTMENT:
LOT DRAINAGE INSPECTION:
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
CITY SECRETARY:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE:
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
M
**TO BE FILLED OUT BY BUILDING OFFICIAL"
ZONING DISTRICT OF INSPECTION LOCATION: C OCCUPANT LOAD:
TYPE OF BUILDING: rGROUP AND DIVISION:
ZONING RESTRICTIONS:
C kFORMSDSCOINFORMATIONIWORKORDER
12MOIN Rev. f421312024