HomeMy WebLinkAboutCO2025-004610UNDER CONSTRUCTION
TD — NO LETTER
SENT LETTER
PW OR LD N E EULD
C'ENDING HIEki'H
LANDSCAPN6_/
HOLD FILE
,CHANGENAME/ OWNER —NEW CONST /ADDITION PERMIT#
NEW TENANT /OCCUPANT REMODEL/ ALTERATION PERMIT#
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ISSUE DATE FINAL DATE
APPLICATION FORM COMPLETED
WORKORDER FORM COMPLETED
ENVIRONMENTAL NOTIFIED DATE I.-,—,,-- TIME
(E-MAIL JIMMY & VALERIE FARRELL
HAZARDOUS MATERIAL SAFETY DATA SHEETS TO FIRE DATE
(SCAN TO C/O IN MYGOV - IF LARGE SET. ALSO SCAN TO LF & FORWARD SET TO F1
FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATE,,
ZONING CHECKED & COMPLETED ON APPLICATION
L a E _*_ L- a Z j'kjq_ a,
HEALTH INSPECTION
CITY SECRETARY (ALCOHOL)
PUBLIC WORKS INSPECTION
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 WORKS SIGN OFF
LOT DRAINAGE SIGN OFF
LANDSCAPING SIGN OFF
BUILDING OFFICIALS SIGNATURE
C/O CERTIFICATE ISSUED
T
DATE IME
DATE TIME
FIRE INSPECTOR:
NOTIFICATION DATE:
NOTIFICATIONDATE:
E-MAIL DATE
E-MAIL DATE
DATE__
LETTER: YES I NO
LETTER: YES / NO
ELECTRIC RELEASED,...................................
SCAN CERTIFICATE I'D MYGOV . . . . .. .... ..... . . . .. ........
MAILED:
GAF ORMS�DSCONFOWAI 10MCKLIST
12i,301LIA 1 Re 5123/24
I U V h
PERMIT #:
CERTIFICATE OF OCCUPANCY PCE EST
FEE: $50.00
IZIC IMF,% IF TVF—r—F,ff1ELCA1"F OCCUPANCY IS ASSOCIATED WITH AN ACTIVE CURRENT BUILDING PERMI'
ADDRESS OF OCCUPANC'Z': 2646 WILLIAM D TATE AVE GRAPEVINE TX 76051-3921 SUITE #
LOT: BLOCK: SUBDIVISION:
****CERTMCATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION""
NAMIE OF BUSINESS: Golden Glaze Donuts
NEW OCCUPANT: YES X NO NEW BUILDING/PROPERTY OWNER: YES NO x
NEW BUILDING: YES NO X NEW BUSINESS NAVE CHANGE: YES NO
NUMBER OF EMPLOYEES: 2NEW BUSINESS OWNER: YES —NO
FREIGHT FORWARDING: YES _ NO
TYPE OF BUSINESS: Bakery
**IF OFFICE/WAREHOUSE PROVIDE BREAKDOWN OF SQUARE FOOTAGES:
SF OFFICE: SF WAREHOUSE: TOTAL SQUARE FOOTAGE: 900
NAME OF TENANT �'PFRSON:N Jack Yen
M
114 V 61&11
lei 0 6116,11
PHONE NUMBER:
PHONE NUMBER:
+ IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate) -------
YES X NO _
+ WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes, provide copy of Alcoholic Beverage Permit) ---
YES _NO X
+ WILL THERE BE FOOD SALES? (if yes, contact Tarrant County Health 817-321-4983 for more information) - -
YES X NO
+ PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? ---------------------
YES X NO
+ WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? --------
YES _ NO --L
+ WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY? (screening is required)
YES _NO x
+ WILL THERE BE ANY OUTSIDE STORAGE (including storage of company/fleet vehicles), DISPLAY/ USE/DINING? YES _ NO X
# WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? ----------------------------
YES —NO X
+ IS BUILDING SPRINKLERED? ----------------------------------------------------------
YES —NO x
+ WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS?
(if yes, provide list of types & quantities, along with material safety data sheets) -------------------------
YES NO X
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 thne of the scheduled inspe000 ction, a $ .re-igs
5 spection fee Will be charged)
FOR QUESTIONS or to RE -SCHEDULE, PLEASE CALL (817) 410-3165 or (817) 410-3166
SIGNATURE:
PRINT NAME: Jack Yen
PHONE #: 469-545-6657 EMAIL:lioldens;l edonuts@gmail.com
City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099
(817) 410-3165 * (817) 410-3166
C:F0RMMSAPPLJCAT10N5-FEESC0 APP
'jalR
TEXASSALES 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 to and Local Sales Tax in the amount of 8.25 %.
A "Seller or Retaffer" 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. to 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: 32102678433 m.
Signature:
_V4V ITERE DO YOU 1-VANT YO TUR C110 NIPLETED 1,7FRTIFICA TE OF 00-1- PAACV MAILED?
ADMIC SS: 2646 WILLIAM D TATE AVE
TYPE OF CONSTRUCTION: OCCUPANCY: DIVISION:
ZONING DISTRICT: CONDITIONAL USE:
PERNUTTED USE:.. - - ---- OCCUPANT LOAD:
BUILDING DEPARTMENT: DATE:
. ....... . . ... . . ...... . . .. . ....
BUILDING INSPECTOR: DATE:
ZONING APPROVAL: DATE:
FIRE DEPARTMENT: DATE:
...... .. ..
LOT DRAINAGE INSPECTION: DATE:
PUBLIC WORKS DEPARTMENT: DATE:
HEALTH DEPARTMENT: DATE:
CITY SECRETARY: DATE:
LANDSCAPING APPROVA11,; DATE :,,/./
APPROVAL FOR ISSUANCT;" DATE:,,
PO Box 95104 Project # 25-004610
Grapevine, Texas 76099 Project Description: C/O (Donut Shop) "Golden Glaze Donuts"
817) 410-3166
Issued on: 02109/2026 at 12:16 PM
isj•.11ANW-1111
Ave.
SraQevine, TX 76051
LEGAL
ltimberpoint Addition Blk
1 Lot 1
S
PERMIT HOLDER
Jack Yen
COLLABORATORS
Jack Yen
Golden Glaze Donut
(972) 514-9959 Cell
OWNERS
TENANTS
- Jack Yen
Golden Glaze Donut
(972) 514-9959 Cell
INSPECTIONS
1. Final Health Inspection
2. Final Fire Dept Inspection
3. Final Building C/O Inspection
**NAME OF BUSINESS
**TENANT NAME (individual)
"TENANT PHONE NUMBER
APPLICANT E-MAIL
—APPLICANT NAME (individual)
"APPLICANT PHONE NUMBER
Square Footage
*Sales Tax Number
TYPE OF BUSINESS
CONSTRUCTION TYPE
OCCUPANCY GROUP
HEALTH APPROVAL FINAL
INSPECTION (City Use Only)
*Sales Tax
Alcoholic Beverage Sales
Alterations
Change of Business Name
Change of Business Owner
Fire Sprinkler System?
Freight Forwarding Business
Hazardous Material
Industrial Waste
New Building / Addition
New Building / Property Owner
New Occupant / Tenant
9
4. Landscaping
5. C/O APPROVED FOR ISSUANCE
Golden Glaze Donuts
Jack Yen
469-545-6657
Jack Yen
469-545-6657
900
32102678433
Donut Shop
VB
M
25-004610 - Health Department
Approval.pdf
YES
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
YES
Page 1/2
MYGOV.US 25-004610, 02/09/2026 at 12:16 PM Issued by: Amanda Robeson
Number of Employees
2
Outside Refuse/Recycling
NO
Outside Storage
NO
Signs
YES
CONDITIONAL USE REQUIRED?
NO
* OCCUPANCY LOAD
15
* PERMITTED USE
YES
* ZONING DISTRICT
cc
FEE TOTAL
PAID DUE
Certificate of Occupancy $50.00
$50.00 $50.00
TOTALS $50.00
$50.00 $0.00
1 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.
>> (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
February 09, 2026
Signature Date
City of Grapevine Certificate of Occupancy
Project # 25-004610
Page 2/2
MYGOV.US 25-004610, 02/09/2026 at 12:16 PM issued by: Amanda Robeson
From: AmirYoussouf <
Sent: Friday, January 16, 2026 12:55 PM
To: Rachel Martinez
Cc: Connie Cook; Courtney Cogburn; Amanda Robeson; Stanley W. Mwangi
Subject: Golden Glazed Donut (2646 William d Tate)
Name: Golden Glazed Donuts
Site: 38979
Location: 2646 William D Tate, Grapevine
Date: 1/16/26
Delivery: mail
11
C"ERTI Fl CATE OF OCCUPANCY
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C iF()RMSkDSCOINFORMAIION�VVOF�KORDER
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