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DATE OF ISSUANCE: UL 18 20,16
el PERMIT #:
BUILDING PERMIT APPLICATION
(PLEASE PRINT LEGIBLY — COMPLETE ENTIRE FORM)
JOB ADDRESS:
• C
SUBDIVISION: Vizi
r
M
BUILDING CONTRACTOR (company name):
CURRENT MAILING ADDRESS: L q QZ PX UIW6 .
CITY/STATE/ZIP: 5 lbqu PH: # . , 2 Z_Z1 Fax # 7
PROPERTY OWNER: VIA
CURRENT MAILING ADDRESS: 'it ! I r " flLL)
CITY/STATE/ZIP: PFS 8 PHONE NUMBER: 61 14 1,'2'2,5
PROJECT VALUE: $ 12R7x, CIO FIRE SPRINKLERED? YES NO
WHAT TRADES WILL BE NEEDED? (Check ones that apply) ELECTRIC PLUMBING MECHANICAL
DESCRIPTION OF WORK TO BE DONE: ,P S
USE OF BUILDING OR STRUCTURE: Rjesmw6c
Total Square Footage under roof:
Im
Square Footage of alteration/addition: 4 8osr
-
I hereby certify that plans have been reviewed and the building will be inspected by a certified energy code inspector in accordance with
State Law. Plan review and inspection documentation shall be made available to the Building Department (required for new buildings,
alterations and additions)
❑ I hereby certify that plans have been submitted to the Texas Department of Licensing and Regulation for Accessibility Review.
Control Number: (Not required for 1 & 2 family dwellings)
❑ I hereby certify that an asbestos survey has been conducted for this structure in accordance with the regulatory requirements of the Texas
Department of Health.
(REQUIRED FOR DEMOLITIONS, ADDITIONS AND OR ALTERATION TO COMMERCIAL AND PUBLIC BUILDINGS)
I hereby certify that the foregoing is correct to the best of my knowledge and all work will be performed according to the documents approved by
the Building Department and in compliance with the City Of Grapevine Ordinance regulating construction. It is understood that the issuance of
this permit does not grant or authorize any violation of any code or ordinance of the City Of Grapevine. I FURTHERMORE UNDERSTAND
THAT PLANS AND SPECIFICATIONS ARE NOT REVIEWED FOR HANDICAPPED ACCESSIBILITY BY THE CITY, AND THAT THE
DESIGN PROFESSIONAL/OWNER IS RESPONSIBLE FOR OBTAINING SUCH APPR V F O T PRIATE STATE AND
OR FEDERAL AG CY(S).
PRINT NAME{ A S`� C"' SIGNATURE
PHONE #: 4o • >,m � EMAIL: * , �
❑ CHECK BOX IF PREFERRED TO BE CON CTED BY E-MAIL
THE FOLLOWING IS TO BE COMPLETED BY THE BUILDING INSPECTION DEPARTMENT
Construction Type: \jB
Permit Valuation: $ -5
Setbacks
Approval to Issue
Occupancy Group:
Fire Sprinkler: YES NO
Front:
Electrical
Division:
Zoning:
Building Depth: -m
Building Width:
Left: —
Rear: —
Plumbing
Mechanical ~�
Occupancy Load:
Right:
Plan Review Approval:
Date: "I �) • 2,ol6
Building Permit Fee:
Site Plan Approval:
Date:
Plan Review Fee:
Fire Department:
Date:
Lot Drainage Fee:
Public Works Department:
Date:
Sewer Availability Rate:
Health Department:
Date:
Water Availability Rate:
Approved for Permit:
Date: -7-1 1
Total Fees:
:14 -
Lot Drainage Submitted:
Approved:
Total Amount Due:
P.O. BOX 85704, GRAPEVINE, TX 76099 (817)4 1 D-3165Qa�_
O'FORMSTSPERMITAPPLICATIONS 1/02 -Re 11/04,5M 2107.11/09 A(11
OARLAND . TEXAS, 75042
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E DOES NOT AI FR-,j�tk ly WORK IN CONFLICT
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)WING ORDINANCE &
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BY
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According to the-F.I.R.M. for the City of Grapevine,Texas
Community Panel No. 480598 0015B, effective date November
17, 1982, all of the property shown hereon is in Zone C,
or no portion of this lot lies within the 100 year flood
plain. A F.
y is hereby
Tbls'surVe_
a 4 and a Ved
L F .... NORMAN
4**3*6*
r
TO ALL PARTIES INTERESTED IN PREMISES SURVEYED:
THM IS TO CVJtTITY THAT I XAVX THIS DATX MADX A CAltrJrLM AND ACCURATS SU]FtVXY CM 'TrUZ OR015
OT PROPXRTY L4:)CILTJM AT NO. I gbaQ�w —IN Tux =ry or_!;���.
DSWRUW AS YOLLOWS: IOT NO. I -q WO= No �IZOF bfbaQ62W
--- qa—ADDITION TO THS CrTY Or_jZg�,' 72XA., ACCOADINd 7V
PLAT JUMOADM PA09_AL_0r TjM.JL46P 21rccamr
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7. 00'
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According to the-F.I.R.M. for the City of Grapevine,Texas
Community Panel No. 480598-0015B,
17, effective date November
1982, all of the property shown hereon is in Zone C,
or no portion of this lot lies within the 100 year flood
plain.
This survey Is hereby OF /71Z
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a d enda ve
it e
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36
TO ALL PARTIES INTERESTED IN PREMISES SURVEYED -
TMS IS To C=TVY THAT I HAVIL TWO DATIL MADS A CARMUL A -ND ACCURATZ WRVZy ON Tat CMO
Or PROPUTY LOCA"M AT. NO. X&L'2wdew-C� �'� IN Tm crry cw-QaWAea,
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or ZC
ADDITION To nM CM a
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7. 00'
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D p / /,/ E -
According to the-F.I.R.M. for the City of Grapevine,Texas
Community Panel No. 480598-0015B,
17, effective date November
1982, all of the property shown hereon is in Zone C,
or no portion of this lot lies within the 100 year flood
plain.
This survey Is hereby OF /71Z
*,s
a d enda ve
it e
.;ORMAPI L, NE4L'�
36
TO ALL PARTIES INTERESTED IN PREMISES SURVEYED -
TMS IS To C=TVY THAT I HAVIL TWO DATIL MADS A CARMUL A -ND ACCURATZ WRVZy ON Tat CMO
Or PROPUTY LOCA"M AT. NO. X&L'2wdew-C� �'� IN Tm crry cw-QaWAea,
DUSMUSID AS VOLLOWS. WT No. T.
UEe— -TW.
or ZC
ADDITION To nM CM a
jae.ia:aj, TJOCAS, ACV •, o. f d TO
PLAT RXWP-DXD IN VOI-ZIZXAT PAGIC -jM_oy TIM UAp RWORDS Orzecr-Q�00UWTT. Tw
T'M P%AT MOMON W A TRUlt, C*ARjjCT AND ACCtMATIC
&D wr &MVVY, THX- • I
Z129, LOCATION An nwDzc7ATjw Vy THS
TM so SHOVOW, ALL DAWROMCWTIS im
AM THAT TWX D LIfM TAX DIDTANCIC INDICA-
Aft WO ROAD 16 AS SHOWN ON SAID PI
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