HomeMy WebLinkAboutCO2025-004259UNDER CONSTRUCTION
TD — NO LETTER
SENT LETTER
PW OR LD NEEDED
PENDING FIRE
PENDING HEALTH
LANDSCAPING / CODE
HOLD FILE
ISSUE DATE FINAL DATE
1. APPLICATION FORM COMPLETED
2. WORKORDER FORM COMPLETED
3. ENVIRONMENTAL NOTIFIED DATE TIME
(E-MAIL JIMMY BROCK,0,6-1��-yu --ory & VALERIE FARRELL
-p'-py
—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 DEPARTMENTAP PROVAL OF HAZARDOUS MATERIAL DATE
—6 ZONING CHECKED & COMPLETED ON APPLICATION
T BUILDING INSPECTION SCHEDULED DATE TIME
—8. FIRE DEPT INSPECTION SCHEDULED DATE TIME
FIRE INSPECTOR:
HEALTH INSPECTION NOTIFICATION DATE:
10. CITY SECRETARY (ALCOHOL) NOTIFICATIONDATE:
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 Off)
18. PUBLIC WORKS SIGN OFF
19. LOTDRAINAGE SIGN OFF
20 LANDSCAPING SIGN OFF
—21. BUILDING OFFICIALS SIGNATURE
22. C/O CERTIFICATE ISSUED
ELECTRIC RELEASE:.,:
SCAN CERTIFICATE TO MYG&
F M V" U, MAILED.
CAFORMSOSCOINFORMA I IONVA(LIST
12/30M\Rv 5123124
DATE
f) PVRFvf IT #:
V
CERTIFICATE OF OCCUPANCY RE' UEST
FEE: $50.00
NO FEE REQUIRED IF THE CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITHANACTIVE CURRENTBUILDING PERM]]
" A DDROF OPA2,1 Al Alain SUITE # � qO ESS CCUNCY: b ---
LOT: J- BLOCK: ;I— SUBDIVISION: /Vorrh P/ace,
""CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION""
. e -Fhe_#-e<p1
NAME OF BUSINESS:, (,77r70-rPe-V1P?
NEW OCCUPANT: YES NO — - NEW BUILDINN�"CROPERTY OWNER: YES—NO--it—
NEW BUILDING: YES NO V NEW BUSINESS NAME CHANGE: YES NO
NUMBER OF EMPLOYEES: NEW BUSINESS OWNER: YES --NO
FREIGHT FORWARDING: YES NO
TYPE OF BUSINESS: 04i ae, Retail Clothing/ Attorney's Mice/ Restaurant/ Ofrice/Warehouse)
**IF OFFICE(WAREHOUSE PROVIDE BREAKDOWN OF SQUARE FOOTAGES:
SF OFFICE: SF WAREHOUSE: -1-1-11-11 11'r TOTAL SQUARE FOOTAGE:
NAME OF TENANT [PERSON'SAnn4 z44i'cAelle,
CURRENT NLAILING ADDRESS: ,�'horewC)
CITY/STATEIZIP:r.A e PHONE NUMBER:
PROPERTY OWNER:
MAILING ADDRESS: A/ '1146it,
7,� 7
CITY/STATEIZIP: PHONE NUMBER:
# IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate) -------
YES
NO
0 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) - -
YES
NO V
# PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? ---------------------
YES
NO
# WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? ........
YES
NO:Z
# WILL OUTSIDE REFUSE(RECYCLING/COMPACTING CONTAINERS BE NECESSARY? (screening is required)
YES
NO
# 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
# IS BUILDING SPRINKLERED? ----------------------------------------------------------
YES
V NO
# WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS?
(if yes, provide lid of types & quantities, along with material safety data sheets) ------------------_-----
YES
— NO
I HEREBY CTRTWY 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 buillding1space is not provided at the tinte of the scheduled inspection, a $50.00 re-insvection fee will be charged)
FOR QUESTIONS or to RE -SCHEDULE, PLEASE CALL (817) 410-3165 or (817) 410-3166
SIGNATURE: _4411o_wl ^4&ekAl� PRINT NAME: 141,111 4�
PHONE#. EMAIL: a n vi
Grapevine * P.O. Box 95104 * Grapevine, Texas 76099
(817) 410-3165 * (817) 410-3166
VDW.,prabevinetexas.nov (OVFR)
TEXAS SALES TAX
TeNas, 18-41", Tax Is Charged and collected on sales within the State and City of Grapevine, Texas of "taxable items." Taxable
items include of 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 "Seiler 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 busineW' includes any location at which three or more orders are received byte "Seller or Retailer
in a calendar year. It an order is received at the place of business of a retailer in Texas, but delivery ors i et 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.
TexasSales Tax Number:
Signature:
WHERE DO YOU WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED?
ADDRESS:- N
Z7
CITY, STATE, ZIP: &4�,_eI4 j2?.
I A 1 14141121 a III DKIN11 DLIJ101
MEW W, I " I 13
ZONING DISTRICT: F (31 CONDITIONAL USE:
PERMITTED USE: OCCUPANT
BUILDING DEPARTMENT: DATE:,
BUILDING INSPECTOR:____ DATE: IJ
ZONING APPROVAL: DATE:
IFIRE DEPARTMENT:
LOT DRAINAGE INSPECTION -
HEALTH DEPARTMENT:
CITY SECRETARY-
LANDSCAPINGAPPROVAL:_
APPROVAL FOR ISSUANCE:
City of Grapevine
Certificate of Occupancy
PO Box 95104
Project # 25-004259
Grapevine, Texas 76099
817)410 -3166
Project Description: C/O (Medical Office) "Grapevine Massage
Therapy"
% POS,
Issued on: 12/16/2025 at 8:31 AM
X
ADDRESS
INSPECTIONS
4
621 N Main St., 440
Grapevine, TX 76051
1. Final Fire Dept Inspection 3. Landscaping
2. Final Building C/O Inspection 4. C/O APPROVED FOR ISSUANCE
LEGAL
North Main Place Blk I
INFORMATION FIELDS
Lot 1
**NAME OF BUSINESS Grapevine
Massage Therapy
PERMIT HOLDER
**TENANT NAME (individual)
Anna Michelle
Anna Michelle
Grapevine essage The
M; :
TENANT PHONE NUMBER
217-508-7901
ry
ap
—APPLICANT NAME (individual)
Anna Michelle
(217) 508-7901
**APPLICANT PHONE NUMBER
217-508-7901
COLLABORATORS
Square Footage
170
- Anna Michelle
*Sales Tax Number
N/A
Grapevine Message
** TYPE OF BUSINESS
Medical Office
Therapy
* CONSTRUCTION TYPE
VB
(217) 508-7901
* OCCUPANCY GROUP
B
OWNERS
'Sales Tax
NO
- Calvo North Main
Fire Sprinkler System?
YES
Street Lic RE: JUAN
CALVO
New Occupant / Tenant
YES
Number of Employees
TENANTS
Alcoholic Beverage Sales
NO
• Anna ichelle
M
Alterations
NO
Grapevine Message
Therapy
Change of Business Name
NO
(217) 508-7901
Change of Business Owner
NO
Freight Forwarding Business
NO
Hazardous Material
NO
Industrial Waste
NO
New Building / Addition
NO
New Building / Property Owner
NO
Outside Refuse/Recycling
NO
Outside Storage
NO
Page 112
MYGOV.US 25-004259, 12/16/2025 at 8:31 AM Issued by: Amanda Robeson
11 ILI &I V IT, F-11 &I'L11114 I :141
Signs
Square Footage - Office
* CONDITIONAL USE REQUIRED?
* OCCUPANCY LOAD
* PERMITTED USE
* ZONING DISTRICT
FEE
Certificate of Occupancy
TOTALS
TOTAL PAID DUE
$50.00 $50.00 $50-00
$50.00' $50.00. $0.00
I HEREBY 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.
>> (it 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
it of Grapevine Certificate of Occupancy
Project # 25-004259
Page 2/2
Issued by: Amanda Robeson
RTI F I CATE OF OCCUPANCY
pi re TIMWT&fo- Ma p- I A M
**TO BE FILLED OUT BY BUILDING OFFICIAL**
ZONING DISTRICT OF INSPECTION LOCATION: OCCUPANT LOAD:,-,._ -
TYPE OF BUILDING: V.5 GROUP AND DIVISION:
ZONING RESTRICTIONS:
C TORMSWSCOINFORMAT 10NMORKORDER
12/30104 Rev IC312024