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Home My WebLink AboutPLBG2017-3368 " SEP 5 2017 CITY OF GRAPEVINE SEA 17 (CIRCLE ONE) MECHANICAL - ELECTRICAL - PLUMBING - IRRIGATION - FUEL GAS PERMIT APPLICATION PLEASE PRINT LEGIBLY—COMPLETE ENTIRE FORM) PERMIT# i �y BLDG.PERMIT DATE: JOB ADDRESS: Iql S a 56f7 ` SUITE#I DESCRIPTION OF WORK: CG w �/j PROPERTY OWNER: CONTRACTING COMPA Y: ADDRESS: ADDRESS: --e r_ -:* ' f s. I CITY/STATE/ZIP: CITYISTATEIZIP: PHONE NUMBER: 9/ 7-c2, ) 2CIS- ✓I PHONE NUMBER: TYPE OF OCCUPANCY BUILDING AREA(S FT PERMIT FEES AMOUNT DUE/ ` Q EACH TRADE I. R-3 1 - 749 $ 33.25 SINGLE FAMILY, DUPLEX 750— 1,199 $ 49.88 TOWNHOUSE, 1,200- 1,500 $ 63.18 NEW CONSTRUCTION& 1,501 - 1,750 $ 76.48 ADDITIONS(PER UNIT) 1,751 - 2,000 $ 83.13 2,001 - 2,250 $ 89.78 TOTAL SQ. FOOT UNDER 2,251 - 3,000 $ 96.43 ROOF 3,001 - 3,500 $ 103.08 3,501 - 4,000 $ 109.73 $ 4,001 + $ 120.37 - EACH TRADE II. A, E, I, R-1 1 - 500 $ 37.00 HOTELS,APARTMENTS, 501 -100000, $ 17.50+.035 PER DRINKING/DINING, 100,001 —500,000 $ 3,500.00+.03 SQUARE EDUCATIONAL,ASSEMBLY, 500,001 + $15,000.00+.02 FOOT $ INSTITUTIONAL EACH TRADE III. B, F, H, M, S, U OFFICE, RETAIL, WHOLESALE, 1 - 500 $ 37.00 GARAGES, FACTORIES, 501 - 50,000 $ 32.00+ .01 PER WORKSHOPS,SERVICE 50,001- 100,000 $ 182.00+ .007 SQUARE STATIONS, WAREHOUSE 100,001+ $ 582.00_+ .00_3 FOOT $ CONTRACT EACH TRADE IV. ANY OCCUPANCY GROUP VALUATION OF WORK FINISH-OUTS, SHELL COMPLETIONS, 0- 500 $ 37.00 ALTERATIONS OR 501- 1,500 $ 45.00 STAND ALONE PERMITS 1,501- 3,000 $ 57.00 3,001- 5,000 $ 72.00 CONTRACT VALUATION OF WORK: 5,001- 50,000 $ 27.00+ .009 $ �� 50,001-100,000 $ 127.00+ .007 PER 100,001-500,000 $ 327.00+ .005 IVALUATI DOLLAR $ "v 500,001+ $ 1,327.00+ .003 ON EACH TRADE V. MISCELLANEOUS I TEM $ 37.00 BILE HOME SERVICE $ 37.00 TEMPORARY POLE SERVICE $ 37.00 SWIMMING POOLS $ 37.00 SIGN ELECTRIC $ 37.00 $ OAFORMS%DS APPLICATIONS-FEES\MEP APPLICATION 4-11.doc PLAN SUBMITTAL: WHEN PLANS ARE REQUIRED BY CODES, ORDINANCES, OR AS DETERMINED BY THE BUILDING OFFICIAL, THREE (3) SETS OF PLANS SHALL BE SUBMITTED IN HARD COPY FORMAT. ENGINEER SEALED PLANS AND CALCULATIONS SHALL BE SUBMITTED AS REQUIRED BY CODES, ORDINANCES OR WHERE OTHERWISE REQUIRED BY STATE LAW. OTHER INSPECTIONS AND FEES: • INSPECTIONS OUTSIDE NORMAL BUSINESS HOURS(2HR MINIMUM)...............................................$42.00/HOUR' • REINSPECTION FEES.................................................................................................................. $42.00 • PERMITS FOR WHICH NO FEE IS SPECIFICALLY INDICATED........................................................... $37.00 INSPECTIONS FOR WHICH NO FEE IS SPECIFICALLY INDICATED(112 HOUR MINIMUM)......................$42.00/HOUR • ADDITIONAL PLAN REVIEW REQUIRED BY CHANGES,ADDITIONS, OR REVISIONS TO APPROVEDPLANS.......................................................................................................................$42.00/HOUR • BUILDING PERMIT FEES FOR THE GRAPEVINE-COLLEYVILLE INDEPENDENT SCHOOL DISTRICT SHALL BE 25%OF THE FEES ESTABLISHED IN THIS TABLE • FOR USE OF OUTSIDE CONSULTANTS FOR PLAN CHECKING AND INSPECTIONS,OR BOTH.........ACTUAL COSTS" 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 CODES 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 FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH ANY FEDERAL, STATE, AND ! OR LOCAL LAW REGARDIN NERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS, AND THAT VEK[f ICAT ENERGY CODE COMPLIANCE SHALL 7B1TTED TO THE CITY UPON REQUEST. SIGNATURE OF CO RACTOR OR AUTHORIZED AGENT PRINTED NAME (OR HOMEOWNER FOR HOMEOWNERS PERMITS) PHONE#: 1 ` O(, EMAIL: FOR THE TOTAL HOURLY COST TO THE JURISDICTION WHICHEVER IS GREATER. —ACTUAL COSTS INCLUDE ADMINISTRATIVE AND OVERHEAD COSTS. Development Services Department,Building Inspections The City of Grapevine*P.O.Box 95104*Grapevine,Texas 76099 *(817)410-3165 Fax(817)410-3012*www.grapevinetexas.gov OAFORMSDS APPLICATIONS-FEESWEP APPLICATION 4-11.doc PLUMBING PERMIT {VALUE} I] 'E Issue Date:September 5,2017 T r. I X PROJECT DESCRIPTION:Replace Double Check Assembly PROJECT# (817)410-3010 WWW.mygov.us PLBG-17-3368 Inspections Permits City of Grapevine LOCATION LEGAL P.O.Box 95104 4157 Heartstone Dr. Countryside East Addition Blk 4 Lot 13 Grapevine,TX 76099 ry Grapevine,TX 76051 No.4220 Tr 13 (817)410-3165 Voice "05182905* (817)410-3012 Fax CONTRACTOR INFORMATION Calvert Irrigation County P Tarrant State ID#L10022306 Square Footage P.O.Box 158 VALUATION 500 Hurst,TX 76053 (817)800-5458 Phone FEES TOTAL=$37.00 calve rtirrigation1 @gmail.com Plumbing Permit Fee{VALUE} $37.00 OWNER PAYMENTS TOTAL=$37.00 Esther Janet Young 4157 Heartstone Dr Calvert Irrigation(Carson Calvert) Grapevine,TX 76051-6547 Other on 0910512017 ($37.00) Note:CC5029 ph.(817)267-3487 NOTICES AVAILABLE INSPECTIONS ALL work must be done in compliance with the 2006 INTERNATIONAL ► Plumbing Tub Seal(required) PLUMBING CODE. ► Backflow Device Inspection(required) ► TCEQ Backflow Certification Submit (required) PLAN SUBMITTAL:WHEN PLANS ARE REQUIRED BY CODES, ► Plumbing Customer Sevice Inspection ORDINANCES,OR AS DETERMINED BY THE BUILDING OFFICIAL,THREE (required) (3)SETS OF PLANS SHALL BE SUBMITTED IN HARD COPY FORMAT. ► Plumbing Final(required) ENGINEER SEALED PLANS AND CALCULATIONS SHALL BE SUBMITTED AS REQUIRED BY CODES,ORDINANCES OR WHERE OTHERWISE REQUIRED BY STATE LAW. READ AND SIGN 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 CODES 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 FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH ANY FEDERAL,STATE,AND I OR LOCAL LAW REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS,AND THAT VERIFICATION OF ENERGY CODE COMPLIANCE SHALL BE SU I D TO CITY UPON REQUEST 6-f77 MYGOV.US City of Grapevine I PLUMBING PERMIT{VALUE)I PLBG-17-3368 I Printed 09/05/17 at 9:01 a.m. Page 1 of 3 SFP 4 201,E CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS; GRAPEVINE ANNUAL TEST PWS I.D.# 2200013 IRRIGATION OTHER'_ NAME OF BUSINESS WHERE DEVICE IS LOCATED:, ," ADDRESS OF SITE SERVICED; PLUMBING PERMIT IF APPLICABLE; # TESTER LICENSE NUMBER: 2:; ¢71!!5-Z"?� EXPIRES: ' DATE OF LAST TEST GAUGE CALIBRATION: THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TCEQ REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS, TYPE OF ASSEMBLY REDUCED PRESSURE PRINCIPLE PRESSURE VACUUM BREAKER DOUBLE CHECK ATMOSPHERE VACUUM BREAKER MANUFACTURER: j�✓j SIZE; MODEL: 3) SERIAL NUMBER: PHYSICAL LOCATION OF METER: /'�i� li� fin REDUCED PRESSURE PRINCIPLE.o. n - - - — - _ ASSEMBLY PRESSURE VACUUM BREAKER DOUBLE CHECK VALVE — -- -- _ _ ASSEMBLY . AIR INLET CHECK VALVE 11T CHECK 2ND CHECK RELIEF VALVE � Open at psid psid DC-Closed.'fi Initial TRP psid S' 6 Opened at p Test Did not open Leaked Leaked Leaked psid Repair Materials — — - — - �_ Used Test DC-Closed Tight After Opened at Opened at Closed Tight psid Repair , RP - psid psid I psid The above is certified to be true. - TESTERS FIRM NAME: BackflowPreventer Testing& ADDRESS: _ _ _ CITYISTATE/ZIP: 2616 Handley�Dr. DATE: �/Z -17 _ --------PHONE NUMBER: 817-7050237 PRINT NAME: SIGNATURE: �TION DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPE AT ) 410-3090 0:4 ORNISOS IRRIGATION INFO\OAC'KFLO\V TEST REPORT.dn Revised:U06.2dO