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Home My WebLink AboutCO2026-0000025UNDER CONSTRUCTION TD — NO lil LETTER SENT LETTER PW OR LD NEEDED PENDING FIRE PENDING HEALTH'—L LAN DSCAPI I IOLD FILE AM to] 0 1 *01 L a CHANGE NAME / OWNER NEW CONST /ADDITION PERMIT#—-, NEW TENANT / OCCUPANT REMODEL /ALTERATION PERMIT# 2 3 4 5 6 7 8 m 21 22. ISSUE DATE FINAL DATE APPLICATION FORM COMPLETED WORKORDER FORM COMPLETED ENVIRONMENTAL NOTIFIED DATE TIME (E-MAIL JIMMY BROCK & VALERIE FARRELL a.. A 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) FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL 7C)N1IKf(-- ckp(,KF-n A rrwpi F:7pn ON APPI ICATION 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 c.rry SECRETARY (Alcohol License Sign Off) PUBLIC, WORKS SIGN OFF LOT DRAINAGE SIGN OFF LANDSCAPING SIGN OFF BUILDING OFFICIALS SIGNATURE C/O CERTIFICATE ISSUED DATE TIME DATE TIME FIRE INSPECTOR: NOTIFICATION DATE,- NOTIFICATIONDATE. E-MAIL DATE E-MAIL DATE DATE LETTER: YES / NO LETTER: YES / NO ELECTRIC RELEASED SCAN CERTIFICATE TO MYGOV C i% A, MAILED 'F� C. V 0RMS\DSG01Nf"0RMATj0N%CKL1S r 1.1130104 \ Rev 5/23124 DATE OF ISSUANCE: PERMIT#: CERTIFICATE OF OCCUPANCY RFOUEST FEE: $50.00 W & I off LOT: 11BR1 BLOCK: 1 SUBDIVISION: CLEARVIEW PARK ADDITION ****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION*-,.':** 1 30-91RI'M41A 12112 NEW OCCUPANT: YES - NO X NEW BUILDING/PROPERTY OWNER: YES NO X NEW BUILDING: YES - NO X NEW BUSINESS NAME CHANGE: YES -NO X NUMBER OF EMPLOYEES: X NEW BUSINESS OWNER: YES -NO X FREIGHT FORWARDING: YES -NO X TYPE OF BUSINESS: CLEAN AND SHOW - MED. OFFICE *11F OFFICE[WAREHOUSE PROVIDE BREAKDOWN OF SQUARE FOOTAGES: SF OFFICE: x SF WAREHOUSE: TOTALSQUAREFOOTAGE: X CA X - NAME OF TENANT Chris PeIrine CURRENT MAILING ADDRESS: 301 N Washin(jon Ave 113MINM, W0737NI11=1110MOTWOM + IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate) ------- YES_NO X + WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes, provide copy of Alcoholic Beverage Permit) --- YES —NO X 4 WILL THERE BE FOOD SALES? (if yes, contact Tarrant County Health 817-321-4983 for more information) - - YES NO X + PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? --------------------- YES NO _X # WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO —NO X * WILL OUTSIDE REFUSEIRECYCLING/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 _T 4 WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? ---------------------------- YES NO X + IS BUILDING SPRINKLERED? ---------------------------------------------------------- YES NO + 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 SAH) 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,�50.00 re -inspection fee will be charged) FOR QUESTIONS or to RE -SCHEDULE, PLEASE CALL (817) 41I5 or (817) 410-3166 SIGNATURE: PRINT NAME: Chris PeIrine . .... ........ PHONE#: 828-318-3842, EMAIL: Chris. Services Department The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 (817) 410-3165 (817) 410-3166 z C:FORMSTSAPPLICATJON�FEEMCO APP IMM4 I .I nwg��O 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 rece-- I 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: N/A Signature: ADDRESS: CITY, STATE, ZIP: OFFICE USE TYPE OF CONSTRUCTION: OCCUPANCY: DIVISION: ZONING DISTRICT: CONDITIONAL USE: PERMITTED USE: OCCUPANT LOAD. BUILDING DEPARTMENT: DATE: BUILDING INSPECTOR. —Z DATE LOT D)WJAAGE IPISPECTION: CITY SECRETARY: LANDSCAPING APPROVAL: APPROVAL FOR ISSUANCE: DATE: DATE: DATE: DATE: DATE: DATE: DATE: DATE: City of Grapevine Certificate of Occupancy PO Box 95104 Project # 264000025 (arapevine, Texas 76099 Project Description: C/O 'Clean & Show' 1116/26 forwarded to 817) 410-3166 CODE] IM Issued on: 03124/2026 at 9:07 AM ADDRESS INSPECTIONS 3 1600 LanGaster Dr., 101 1. Final Building C/O Inspection 3. C/O APPRO VED FOR ISSUANCE Grapevine, TX 76051 2. Landscaping LEGAL Clearview Park Addition INFORMATION FIELDS Blk 1 Lot I lbrl **NAME OF BUSINESS Vacant PERMIT HOLDER "TENANT NAME (individual) Chris PeIrine Chris Peldne **TENANT PHONE NUMBER 828-318-3842 Baylor Scott and White H ealth APPLICANT E-MAIL chris. 318-3842 `APPLICANT NAME (individual) Chris Pelrine **APPLICANT PHONE NUMBER 828-318-3842 COLLABORATORS - Chris Pelrine Square Footage 2690 Baylor Scott and White TYPE OF BUSINESS Medical Office Health CONSTRUCTION TYPE VB (828) 318-3842 OCCUPANCY GROUP N/A OWNERS 'Sales Tax NO • Lancaster Liquid Alterations NO Investments Signs NO (817) 358-8600 Change of Business Name NO TENANTS Hazardous Material NO • Chris Pelrine Outside Storage NO Baylor Scott and White Health New Building / Addition NO (828) 318-3842 Industrial Waste NO New Building I Property Owner NO Outside Refuse/Recycling NO New Occupant I Tenant NO Fire Sprinkler System? NO Alcoholic Beverage Sales NO Change of Business Owner NO Freight Forwarding Business NO Page 1/2 MYGOV.us 26-000025, 03,2412026 at 9:07 AM Issued by: Courtney gbum CONDITIONAL USE REQUIRED? N/A OCCUPANCY LOAD N/A PERMITTED USE NO OCCUPANCY ZONING DISTRICT PO FEE TOTAL PAID DUE Certificate of Occupancy $50.00 $50.00 $50.00 TOTALS $50.00 $50.00 $0.00 I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO TAE 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 tee will be charged) FOR QUESTIONS or TO RECALL FOR INSPECTION, PLEASE CALL: (817) 410- 3165 or (817) 410-3166 Signature City of Grapevine Certificate of Occupancy Project # 26-000025 March 24, 2026 Date Page 212 rim-aimi '', r l�� 1� 11 11 M I" PERMIT # 26o - I .Alo vy't 01 OX' fre&�J41^ **TO BE FILLED OUT BY BUILDING OFFICIAL" ZONING DISTRICT OF INSPECTION LOCATION- OCCUPANT LOAD: TYPE OF BUIL.DING: GROUP AND DIVISION ZONING RESTRICTIONS: CAF ORMSOSGOINFORMAT 10N\WORKORDFH 12/30104 Rev 6;2,i/A,'4