HomeMy WebLinkAboutSFRA2016-14031 -Ir 2 016 DATE OF ISSU/ANCE:
PERMIT #: i A/
BUILDING PERMIT APPLICATION
(PLEASE PRINT LEGIBLY— COMPLETE ENTIRE FORM) -'M65k
LOT: BLOCK: SUBDIVISION:
BUILDING CONTRACTOR (company name):
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G { k0 t G 140o'-,
Setbacks
CURRENT MAILING ADDRESS: --I I c) \-) 0'Lk `.Z `r
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Fire Sprinkler: YES NO
CITY/STATE/ZIP: Ut. L -J t j 1) l l_L' MA
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PH: # 917. ° Z2 / -R $Od
Fax # q)Z 4'j 36 _ Q 8cf 9
PROPERTY OWNER: '�?- o' ')
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Building Width:
CURRENT MAILING ADDRESS: S t
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CITY/STATE/ZIP: 0_, RA PC, y 1 N 4 j�
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l PHONE NUMBER: [ 9- Yk — 6 t S 0
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PROJECT VALUE: $ t ,
Building Permit Fee:'
FIRE SPRINKLERED?
YES NO
Date:
WHAT TRADES WILL BE NEEDED? (Check ones that apply) ELECTRIC PLUMBING
MECHANICAL
DESCRIPTION OF WORK TO BE DONE:
k i'A
R / e.G k
USE OF BUILDING OR STRUCTURE: 1M
v°A- `L_.
Sewer Availability Rate:
NAME OF BUSINESS: i`' ) P'r
Date:
Water Availability Rate:
Total Square Footage under roof: Square Footage of alteration/addition:
❑ 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/OWN IS RESPONSIBLEFOR OBTAINING SUCH APPROVAL M T APPROPRIATE STATE AND
OR FEDERAL AGENCY(S). —�' - .., s-1,7
PRINT NAME: L6 G ( it-- SIGNATURE Yz�
PHONE #: Z " 6 i 2 - 916 t EMAIL:
❑ CHECK BOX IF PREFERRED TO BE CO ACTED BY E-MAIL
THE FOLLOWING IS TO BE COMPLETED BY THE BUILDING INSPECTION DEPARTMENT
Construction Type:
Permit Valuation: $ 1,500 -00
Setbacks
Approval to Issue
Occupancy Group:
Fire Sprinkler: YES NO
Front:
Electrical -�
Division:
Building Depth:
Left:
Plumbing
Zoning: s - °
Building Width:
Rear:
Mechanical
Occupancy Load:
Right:
Plan Review Approval:
Date: L4 ° Zt�'4
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: -2cal
Total Fees:
Lot Drainage Submitted:
Approved:
Total Amount Due:
P.O. BOX 95104, GRAPEVINE, TX 76099 (817) 410-3165 OTORMSMSPERMITAPPLICATIONS 1/02-R-.11/04,6106,2"07,11/09.4 11
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APR 19 2016
3
CONTRACTOR SHALL CALL F -OR
INSPEC11ONS:
(817) 410-3010
CONTRACTOR REGISTRATION
WILL BE REVOKED UPON
PERMITEXPIRATION,
THESE PLANS ARE NOT REVIEWED
FOR HANDICAPPED ACCESSIBILITY
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QUY OF GRAERE-VINE
RELEASED FOR CONSTRUCTION
SHEET- OF:
RELEASE DOES NOT AUTHORIZE ANY WORK IN CONFLICT
WITH THE BUILDING CODE OR ZONING ORDINANCE.
THIS PLAN TO BE KEPT ON
THE JOB AT ALL TIMES
DATE: :�b - 2016 BY: —4944�
BUILDING INSPECTION DIVISION
RELEASE DOES NOT APPLY TO CONSTRUCTION IN
EASEMENTS OR PUBLIC RIGHT-OF-WAY.
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KPAMTE PLUMBING, MECHANICAL,
LVzGTRIM. AND SIGN PERMITS
SH"BE RLQUIRED
ICE COPY
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