HomeMy WebLinkAboutCO2026-001285UNDER CONSTRUCTION
TD — NO LETTER
SENT LETTER
PW OR LD NEEDED
PENDING FIRE
PENDING HEALTH
LANDSCAPING / CODE
HOLD FILE
C/O CHECK LIST
C/O PERMIT # 26
eADDRES
_. .
BUSINESSNAME:
BUSINESS t PROPERTY
CHANGE NAME /ADDITION PERMIT#
NEW TENANT/ UPA T REMODEL /ALTERATION PERMIT#,___
ISSUE DATE-- , .., „ .. _... FINAL DATE
APPLICATION FORM COMPLETED
2. WORKORDER FORM COMPLETED
3. ENVIRONMENTAL NOTIFIED GATE ._..,.__.. TIME ,.. �_.....__,...___ .. .
_. (E—MAIL JIMMY SRCC6C jeas� cBa�3,I;w,'wi�t e �.;;ya:::;e� -v�� & 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 FIRE)
5. FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATE
ZONING CHECKED & CO PLE1ED ON APPLICATION
7 BUILDING INSPECTION SCHEDULED DATE.._ TIME _.
3. FIRE DEPT INSPECTION SCHEDULED DATE, TIME .
FIRE INSPECTOR:
0 HEALTH INSPECTION NOTIFICATION DATE
10. CITY SECRETARY (ALCOHOL) NOTIFICATIONDATEe._.,-_._.._w.__...
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
1. FIRE DEPARTMENTS SIGN OFF LETTER: YES / NO
16, HEALTH DEPARTMENT SIGN OFF
17. CITY SECRETARY (Alcohol License Sign Off)
1 . PUBLIC WORKS SIGN OFF
wry LOT DRAINAGE SIGN OFF
_."�_.. 0. LANDSCAPING SIGN OFF
21. BUILDING OFFICIALS SIGNATURE
22, C/O CERTIFICATE ISSUED
ELECTRIC RELEASED:.,....., _
SCAN CERTIFICATE TO MYGOV°
AILED.
C. RF C)Idi�6C)Sd:C)IP9f f)F�MATk{.)h t( ttt IS
itl,'41)1 4tRov ',K'3124
DATE OF ISSUANCE:
PERMIT#:
CERTIFICATE OF OCCUPANCY RE UEST
FEE: $50.00
NO FEE REQUIREDIF CERTIFICATE OF 0
ADDRESS OF OCCUPANCY: SUITE #
LOT: BLOBDIVISION:
****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION****
NAME OF Ba
USINESS: eaxN r-N. o
NEW OCCUPANT: YES NO V"' NEW BUILDING/PROPERTY OWNER: YES_NO
NEW BUILDING: YES NO NEW BUSINESS NAME CHANGE: YES NO
NUMBER OF EMPLOYEfS. FREIGHT FORWARDING: YES NO
NEW BUSINESS OWNER: YES —NO
TYPE OF BUSINESS: CIZ,,V.`-�\,j SV%0LA.) SQUARE FOOTAGE -
I
NAME OF TENANT
CURRENT MAILING ADDRESS:
CITYISTATE/ZIP:
shoo
PHONE NUMBER:
PROPERT• Y OWNER:
MAILING ADDRESS:
CITY/STATE/ZIP: PHONE NUMBER:
+ IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate)----
YES NO
+ WELL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes, provide copy of Alcoholic Beverage Permit)
- YES NO
* PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? -------------------
YES NO
* WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER
* WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY?
(if yes, screening is required) -----------------------------------------------------------
YES NO V'
* WILL THERE BE ANY OUTSIDE STORAGE (including storage of corapany/fleet vehicles), DISPLAY,
USEOR DINING? ------------------------------------------------------------------
YES NO Z
+ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? -------------------------
—
YES _NO
+ IS BUILDING SPRINKLERED? -------------------------------------------------------
YES — NO
* WELL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS?
(if yes, provide list of types & quantities, along with material safety data sheets) ----------------------
YES NO Vl"
I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE REST OF MY KNOWLEDGE AND THE SAID
OCCUPANCY IS IN CONFORMANCE WITH THE INFORMATION HEREIN SET FORTH.
(If access to the building/space is not I provided at the time of the scheduled inspection, a 42.00 on
be charged)
FOR QUESTIONS PLEASE CALL t� 17) 410-3165.
.z
SIGNATURE-' PRINT NAME:
ff" #: EMAIDL:
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (817) 410-3165
Fax (817) 410-3012
TEXASSA. LESTAX
�-Cjtft-.� -ce. Texas of
.41W
A "Seller or Retailer" means a person engaged in the 60311117'36=1 MEVOL"O PAT
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 Wove alka I T711111
Grapevine, Texas if the circumstance applies to my business.
Texas Sales Tax Number:
Signature:
n
119"1111I
MMA
ADDRESS:
CITY, STATE, ZIP:
OFFICE USE
O
DIVISION:
TYPE OF CONSTRUCTION; CCIJPANCY�
PERMITTED USE;
BUILDING DEPARTMENT:
BUILDING INSPECTOR:
ZONING APPROVAL:
FIRE DEPARTMENT:
LOT DRAINAGE INSPECTION,
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
CITY SECRETARY:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE: j
DATE:
DATE:
DATE:
DATE.
DATE:
DATE:
Q-10WX
+:F0SMS%DSAPPLjCAT10NS-FEES
City of .:ram Certificate Occupancy
PC Box 95104 Projectr f/
Grapevine, Texas 76099 Project Description: Clean & Show [Electric release for
410-3166 existing use]
i 01-001150
ADDRESS
2300 William D Tate
Ave.
Grapevine, TX 76051
LEGAL
Charter Hospital Addition
Blk 1 Lot 1
S
Grapevine Valley Hope
Justin Stark
940-233-3131
45000
vacant
IIA
N/A
YES
1
N/A
Occupied; C/O 01-001150 Release
Electric
cc
TOTAL PAID DUE
50.00 $ 50.00 $50.00
$ 50.00 $ 50.00 $ 0.00
READ r SIGN
I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF
MY KNOWLEDGE AND THAT SAID OCCUPANCY IS IN CONFORMANCE WITH
THE INFORMATION
to the building/space is n* provided of r e
inspection, # #1 re -inspection fee will be ♦'r
Page 1/2
MYGOV.US 26-001285, 0412T2026 at 12:24 PM Issued by: Amanda Robeson
FOR QUESTIONS or TO RECALL FOR INSPECTION, PLEASE CALL: (817) 410-
3165 ♦ (817) 410-3166
Signature
Certificate of Occupancy
Project # 26-001285
Page 2/2
MYGOV.US 26-001285, 04/23/2026 at 12:24 PM Issued by: Amanda Robeson
mall"ll"Al W,1111101:49-141&
PERMIT# 26
ADDRESS OF INSPECTION:
GAFoR%q,1;11)8('( ' )INFORNIAl JONMURK(WI)ER
12130f011 R,4v Y:1,3i�024