HomeMy WebLinkAboutCO2025-004231•
C/O PERMIT # 25 -
ADDRESS:
BUSINESS NAME:
BUSINESS 1 PROPERTY
CHANGE NAME /OWNER
NEWTENANT'ibCCUPANT
2.
4,
- 9
12,
—16.
17.
18,
20
21.
22.
UNDER CONSTRUCTION
T D — NO LETTER
SENT LETTER
PW OR LD NEEDED
PENDING FIRE
PENDING flEALTH
LANDSCAPING /CODE 7
HOLD �il_E
ISSUE DATE FINAL DATE . ..... . . ..... -
44 All'i-RDER FORM COMPLETE#
ENVIRONMENTAL NOTIFIED DATE.;: TIME
(E-MAIL JIMMY BROCK y
V &VALERIE FARRELL M:rgf
HAZARDOUS MATERIAL SAFETY DATA SHEETS TO FIRE DATE
(SCAN TO C/O IN MYGOV - IF LARGE SET, ALSO SCAN TO LF & FORWARD SET TO Fl�_E)
FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATA
ZONING CHECKED & COMPLETED ON APPLICATION
HEALTH INSPECTION
CITY SECRETARY (ALCOHOL)
PUBLIC WORKS INSPECT ION
LOT DRAINAGE INSPECTION
CORRECTION LETTER SENT
BUILDING INSPECTORS SIGN OFF
FIRE DEPARTMENTS SIGN OFF
HEALTH DEPARTMENT SIGN OFF
CITY SECRETARY (Alcohol License Sign Off)
PUBLIC OR SIGN OFF
LOT DRAINAGE SIGN OFF
LANDSCAPING SIGN OFF
BUILDING OFFI1f_']ALS SIGNATURE
C/O CERTIFICATE ISSUED
DATE TIME
DATE
TIME
FIRE INSPECTOR'.
NOTIFICATION DATE:
NOTIFICATIONDATE:__,_,,______
E-MAIL DATE
E -MAIL DATE
DATE
LETTER: YES / N 0
LETTER: YES / NO
ELECTRIC RELEASED:
SCAN CERTIFICATE TO MYGOV
MAILED:._...,....... .... . ...........
G tFORMSkDSCOINFORMATION\CKL.ISP'
121,30104 i Rev 51231,M
SSUANCE:DATE OF
PERMIT #:
CERTIFICATE
OCCUPANCY
i 0
ADDRESS OCCUPANCY:
i BLOCK: SUBDIVISION:
****CERTHICATE OF OCCUPANCY WILLNOT ISSUED WITHOUT DESCRIPTION****
NAME OF BUSINESS:
NEW OCCUPANT: O
NEW BUiLDING/PROPERTY
YES
i
t ► 1 iBUSINESS
NEW BUILDING:
► CHANGE:
YES
— NO
NUMBER OF EMPLOYEES:
NEW BUSEWM OWNER:
YES_NO__'__"
FREIGHT FORWARDING-
—NO—
TYPE OF i
**IF OFFICEIWAREHOUSEPROVIDE I► BREAKDOWN OF i i i
SF i i,USE: TOTAL SQUAREFOOTAGE:
# IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (dyes, provide copy of Sales Tax Certificate) -------
YES_NO
t THERE BE ALCOHOLIC BEVERAGE SALES? (ift. provide copy of AlcoholicBeverage Permit)
1 THERE iFOOD i yes, contactTarrantCounty r Health ,; i .�i for more information)
+ PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? ---------------------
YES
_ NO
1 BUSINESS INDUSTRIAL DISCHARGE SEWER
+ WILL OUTSIDE REFUSEIRECYCLINGICOMWACTING CONTAINERS BE NECESSARY? (screening is required)
YES
—NO
4 WILL THERE BE ANY OUTSIDE STORAGE (including storage of company/fleet vehicles), DISPLAY/ USEMINING? YES —
NO
+ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? ----------------------------
YES
—NO
1WILL BUSINESSi OR HANDLE HAZARDOUSEa i m
(if yes, provideof to c quantities, „• with material data r' sheets)
NO
HEREBY t THE i ' i [ CORRECT i' TIRE BEST OF i i ► AND THE SAID
OCCUPANCY IS INCONFORMANCE WITH T `1 1„ i' i HEREIN i H.
access to the buildingtspace is not provided {;' time ' of i' scheduled inspection, a $50.00 re -inspection fee`• be charged)
FOR QUESTIO0-3165t i=i
SIGNATURE:
PRINT1NAME:
PHONE
Building Services e a ent
e City of Grapevine * P.O. Box 95104* Grapevine, Texas 76099
17)41 -31 ( 7)4 -31
TEXAS SALES TAX
0ty"WW " il . I I I . I I - I- -, ''i ' I I I ' I I :: ' ! 1 11 1,, It
111111111i'dil rMint t , ' j I I # I WoMill L a t �Aljkl
11W
A "SeLLer or AeMterl' means a person engaged-m—h
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.
Grapevine, Texas if the circumstance applies to my business.
Texas Sales Tax Number:
ADDRESS:
CITY, STATE, ZIP:
OFFICE USE
TYPE OF CONSTRUCTION: OCCUPANCY: DIVISION:
ZONING DISTRICT: -------- CONDITIONAL USE:
PERMITTED USE: OCCUPANT LOAD:
BUILDING DEPARTMENT:,
BUILDING INSPECTOR:
ZONING APPROVAL:
FIRE DEPARTMENT:
LOT DRAINAGE INSPECTION -
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
CITY SECRETARY:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE:
DATE:
DATE:
DATE:
DATE:
DATE:
City of Grapevine
Certificate of Occupancy
PO Box 95104
Project # 25-004231
V
Grapevine, Texas 76099
Project Description: C/O (Medical Office) "Caribbean
"111
46
817) 410-3166
Chiropractor"
F
Won
Issued on: 12/16/2025 at 9:57 AM
ADDRESS
INSPECTIONS
4
621 N Main St., 100
1. Final Fire Dept Inspection
3. Landscaping
Grapevine, TX 76051
2. Final Building C/O Inspection
4. C/O APPROVED FOR ISSUANCE
LEGAL
North Main Place Blk 1
INFORMATION FIELDS
Lot 1
-NAME OF BUSINESS
Caribbean Chiropractor
PERMIT HOLDER
**TENANT NAME (individual)
Humberto Figueroa -Perez
Humberto Figueroa -Pere
"TENANT PHONE NUMBER
817-660-7734
Z
Caribbean Chiropractor
—APPLICANT NAME (individual)
Humberto Figueroa -Perez
(817) 660-7734
"APPLICANT PHONE NUMBER
817-660-7734
COLLABORATORS
Square Footage
406
- Humberto Figueroa-
*Sales Tax Number
N/A
Perez
TYPE OF BUSINESS
Medical Office
Caribbean
CONSTRUCTION TYPE
VB
Chiropractor
(817) 660-7734
OCCUPANCY GROUP
B
*Sales Tax
NO
OWNERS
Alcoholic Beverage Sales
NO
• Calve North Main
NO
Street Lic RE: JUAN
Alterations
CALVO
Change of Business Name
NO
Change of Business Owner
NO
Fire Sprinkler System?
NO
Freight Forwarding Business
NO
Hazardous Material
NO
Industrial Waste
NO
New Building / Addition
NO
New Building / Property Owner
NO
New Occupant / Tenant
YES
Number of Employees
1
Outside Refuse/Recycling
NO
Outside Storage
NO
Page 1/2
MYGOV.US 25-004231.12116/2025 at 9:57 AM Issued by: Amanda Robeson
Wxm..�
INFORMATION FIELDS
Signs
NO
Square Footage - Office
406
• CONDITIONAL USE REQUIRED?
NO
• OCCUPANCY LOAD
3
• PERMITTED USE
YES
• ZONING DISTRICT
PO
FEE TOTAL PAID
DUE
Certificate of Occupancy $50.00 $50.00
$50.00
TOTALS $50.00 $50.00
$0.00
VA-ADT-11M ICYV
I AEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF
MY KNOWLEDGE AND THAT SAID OCCUPANCY IS IN CONFORMANCE WITH
THE INFORMATION HEREIN SET FORTH.
>> (if access to the building/space is not provided at the time of scheduled
inspection, a $50.00 re -inspection fee will be charged)
FOR QUESTIONS or TO RECALL FOR INSPECTION, PLEASE CALL: (817) 410-
3165 or (817) 410-3166
Signature
Project # 25-004231
5,
Page 2/2
MYGOV.US 25-004231, 12/16/2025 at 9:57 AM Issued by: Amanda Robeson
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-A
#25-004231
CERTIFICATE OF OCCUPANCY
City of Grapevine Permits and Inspections
oancy is hereby issued pursuant to Section 109 of the 2021 International Building Code And Chapter 64 of the
---ehensive Zoning Ordinance. At the time of inspection, this building or space was found to be in compliance with
8'--Alf, and Zoning Ordinances of the city of Grapevine. Any change in use, tenant and/or owner of this building/space
-nev i-
ertificate of Occupancy.
Business Name
-A
i3 aw
--u
PROJECT INFORMATION
Med=10ffice
Ve
PO
V1
1'SSL1E[J BY
signature
H
Property Owner
r.f.A&I4
621 N Main St # 415
Grapevine, TX 76051
Date