HomeMy WebLinkAboutMHCO2016-3718ADDRESS:
DATE:
PERMIT #: /6- 37 )
CERTIFICATE OF OCCUPANCY REQUEST
MANUFACTURED HOME INSPECTION
$42.00
E L C 4.4e. poj i_? Na,/ vj or , /oy �;�rt a:`�c LOT: / 0
What is the size of the manufactured home? (600 Sof, FT MINIMUM)
Will there be any alterations to any structure on the lot?
(If yes, permits are required.)
Do you plan to build any structures or porches?
(If yes, permits are required.)
Will the manufactured home be wired to the power pole?
Will an air conditioner be set and wired?
Will gas be connected?
Will water or sewer be connected?
1. Only state inspected and approved manufactured homes may beplaced in parks. No RV'smotor homes,
recreational park trailers, etc. are permitted. A State Inspection placard must be permanently affixed
to the manufactured home.
2. After the manufactured home has received inspection, a RED or GREEN TAG will be left on the electric meter.
A GREEN TAG will indicate a passed inspection and a RED TAG will indicate a failed inspection.
3. If a RED TAG is received, the manufactured home owner or tenant must have the items indicated on the RED
TAG corrected. After corrections, call our office for a re -inspection. (817) 410-3010.
4. If a GREEN TAG is received, the building department will fax a release to the electric company immediately.
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.
YES /(NO
YES/(
YES /(1:0
YES /CP
YES Kr
PRINT NAME: 0 10 c►yc VC)
SIGNATURE:
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (817) 410-3165
Fax (817) 410-3012 * www.grapevinetexas.gov
OWNER
TENANT
NAME:
R . VU Hoz, ) c } c
NAME:
.4f t)ck rV4
ADDRESS:
e544`.J` NP
ADDRESS:
.
'75j ler izd Sck.
CITY/ZIP:
r` i<C +. i
CITY/ZIP:
6 o SI 4?e v;1
PHONE #:
,1 9 ( / 5
PHONE #:
,g
9 i 0 0
What is the size of the manufactured home? (600 Sof, FT MINIMUM)
Will there be any alterations to any structure on the lot?
(If yes, permits are required.)
Do you plan to build any structures or porches?
(If yes, permits are required.)
Will the manufactured home be wired to the power pole?
Will an air conditioner be set and wired?
Will gas be connected?
Will water or sewer be connected?
1. Only state inspected and approved manufactured homes may beplaced in parks. No RV'smotor homes,
recreational park trailers, etc. are permitted. A State Inspection placard must be permanently affixed
to the manufactured home.
2. After the manufactured home has received inspection, a RED or GREEN TAG will be left on the electric meter.
A GREEN TAG will indicate a passed inspection and a RED TAG will indicate a failed inspection.
3. If a RED TAG is received, the manufactured home owner or tenant must have the items indicated on the RED
TAG corrected. After corrections, call our office for a re -inspection. (817) 410-3010.
4. If a GREEN TAG is received, the building department will fax a release to the electric company immediately.
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.
YES /(NO
YES/(
YES /(1:0
YES /CP
YES Kr
PRINT NAME: 0 10 c►yc VC)
SIGNATURE:
Development Services Department
The City of Grapevine * P.O. Box 95104 * Grapevine, Texas 76099 * (817) 410-3165
Fax (817) 410-3012 * www.grapevinetexas.gov