HomeMy WebLinkAboutCO2017-0507DATE OF ISSUANCE: MAY 12 2017
PERMIT #: / 'z
CERTIFICATE OF OCCUPANCY REQ EST
FEE: $50.00
NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITH AN A CTIVE CURRENT BUILDING PERMIT
ADDRESS OF OCCUPANCY: 30 • k A fg� VIA)F-- Mj.L�kW� —SUITE#
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LOT: BLOCK: SUIDIVRION:
****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION""
NAME OF BUSINESS:
NEW OCCUPANT: YES NO
NEW BUILDING: YES NO
NUMBER OF EMPLOYEES:
NEW BUILDING/PROPERTY OWNER: YES NO
NEW BUSINESS NAME CHANGE: YES NO
FREIGHT FORWARDING: YES NO
NEW BUSINESS OWNER: YES NO
TYPE OF BUSINESS: ker4l(. ne2v_+5 SQUARE FOOTAGE:
(Example- Retail Clothing / Attorney's Office / Office -Warehouse / Restaurant)
NAME OF TENANT (Physical Name): A PP r_- A k A /V CE5S
CURRENT MAILING ADDRESS:. 90(1,S/;:- /_/V
CITY/STATE/ZIP:_P',e_/sco Tx -75035 PHONE NUMBER: 9 -72 -4fl,5
PROPERTYOWNE:
MAILING ADDRESS: (,,,- 1 "4,
CITY/STATE/ZIP: -/ry, PHONE NUMBER:;
7-
71
* IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes, provide copy of Sales Tax Certificate) - - - - YES >< NO
* WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes, provide copy of Alco)i9lic Beve P - YES NO)��
-YES 'K
* PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED? �,_171,,ml NO
+ WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? ----- YES NO, -N
* WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY?
(if yes, screening is required) ----------------------------------------------------------- YES No A
+ WILL THERE BE ANY OUTSIDE STORAGE, DISPLAY, USE OR DINING: - - - - - - - - - - - - - - - - - - - - - YES NOX:
+ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING? ------------------------- YES NO
* IS BUILDING SPRINKLER -ED? ------------------------------------------------------- YES NO
+ WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS? N .
(if yes, provide list of types & quantities, along with material safety data sheets) ---------------------- YES Na -:S,_
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 time of the scheduled inspection, a $42.00 re -inspection fee will be charged)
FOR QUESTIONS TL SE CALL (817) of 3165.
SIGNATURE:
PRINT NAME:
PHONE #:
C/
- U )
EMAIL: ,
(OVER)
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (817) 410-3165
Fax (817) 410-3012 * www.grapevinetexas.gov
0:FORMSXI)SAPPLICATIONSIC/
312212001/Rev:5106,2/07,4109,2113,11115
TEXAS SALES 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 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 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 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:
Signature:
WHERF DO YOU WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCYNISLE D?
ADDRESS:
CITY, STATE, ZIP:
FO OFFICE USE
4
TYPE OF CONSTRUCTION: OCCUPANCY: DIVISION:
ZONING DISTRICT:
PERMITTED USE:
BUILDING DEPARTMENT:
ZONING APPROVAL- /)
FIRE DEPARTMENT:
LOT DRAINAGE INSPECTION:
PUBLIC WORKS DEPARTMENT:
HEALTH DEPARTMENT:
CITY SECRETARY:
LANDSCAPING APPROVAL:
APPROVAL FOR ISSUANCE:
0TORMSNDSAPPLICATIONSIC/
3/22/2001/Rev:5/06,2/07,4109,2/1 3,11115
CONDITIONAL USE:
DATE: 14 f9s C31-1-2)1
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