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Home My WebLink AboutPLBG2017-3813 Issue Date: CITY OF GRAPEVINE (CIRCLE ONE) - MECHANICAL ELECTRICAL - PLUMBING - IRRIGATION - FUEL GAS PERMIT APPLICATION rPLEASE PRINT LEGIBLY-COMPLETE ENTIRE FORM! PERMIT# BLDG.PERMIT# DATE- PERMIT a as JOB ADDRESS: SUIT e# c- DESCRIPTION OF OR K: 2 P.., a PRO ERT"^`""'°O' s� CONTRACTING COMPANY: Cs/'Ij_ eN"f!r trC• �� A+.it�i. 0I L�IG ' ADDRESS: ADDRESS: CITY/ST TEIZIP: CITYISTATEI�IP: ,v A- 76.?s PHONE NUMBE PHONE NUMBER: 3 3 - zdoo �/? TYPE OF OCCUPANCY BUILDING AREA PERMIT FEES AMOUNT DUE (SQ FT 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 -100,000 $ 17.50+.035 PER DRINKINGIDINING, 100,001 -500,000 $ 3,500.00+.03 SQUARE EDUCATIONAL,ASSEMBLY, 500,001 + $15,000.00+.02 FOOT $ INSTITUTIONAL EACH TRADE 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+ .003 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 eci 50,001- 100,000 $ 127.00+ .007 PER $ —j 00 100,001-500,000 $ 327.00+ .005 DOLLAR $ 5.00,001+ $ 1,327.00+ .003 IVALUATION V. MISCELLANEOUS EACH TRADEr1� IRRIGATION SYSTEMS $ 37.00 LL MOBILE HOME SERVICE $ 37.00 TEMPORARY POLE SERVICE $ 37.00 SWIMMING POOLS $ 37.00 SIGN ELECTRIC $ 37.00 $ I C:1 Usersl sbattel AppDatal LocallMicrosoftlWindowslTemporary Internet FleslContent.Outlook1G80E6GOFIMEP 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(1/2 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 REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS, AND THAT VERIFICATION OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST. SIGN F CONTRACTOR OR AUTHORIZED AGENT PRINTED NAME (O OMEOWNER FOR HOMEOWNERS PERMITS) PHONE#:. f 022 .. EMAIL: "OR 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.grapevinctexas.gov C:\Users\sbatle\AppDala\LocallMicrosoft\Windows\Temporary Internet FileslContent:Outlook\GBOE6GOF\MEP APPLICATION 4-11.doc M1 to 1� CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE ANNUAL TEST IRRIGATION PWS I.D.# 2200013 OTHER ;L NAME OF BUSINESS WHERE DEVICE IS LOCATED: PA- Xpe SS ADDRESS OF SITE SERVICED: 300 C.�.�d Qt U ptJ tr 1N.IU,5 4 u9 W S 1 f e,6 (41 1 PLUMBING PERMIT IF APPLICABLE: # 847 7 g 3 TESTER LICENSE NUMBER: E)t c l 3 3&to EXPIRES: 0' 1.5 J vi- DATE OF LAST TEST GAUGE CALIBRATION: l - 7-C) - 1 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 11 ATMOSPHERE VACUUM BREAKER MANUFACTURER: W A 16 5 SIZE: V I t MODEL: L V- 0 01 Q•T SERIAL NUMBER: 133S-03 PHYSICAL LOCATION OF METER: P c x r T-0 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER DOUBLE CHECK VALVE ASSEMBLY AIR INLET CHECK VALVE 1sT CHECK 2ND CHECK RELIEF HALVE DC-Closed Tight• Closed Tight Open at_psid psid Opened at Initial c RP -JLL psid ® Did not open Leaked Test Leaked Leaked psid Repair Materials Used Test DC-Closed Tight Opened at Opened at After Closed Tight psid Repair _RP_ psid psid psid p n The above is certified to be true. n TESTERS FIRM NAME: P(LTC'Y(r A Lv-r- ADDRESS: ) >J. CITYISTATEIZIP: DATE: ) � - 1Zv _ PHONE NUMBER: PRINT NAME: :' 4(15r'61?ph 9-G G SIGNATURE: J- ! DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT(817)410-3010 C:ID000ME-lWh fteILOCALS-1VTemp%XPgNwimITCEQkn,.Y.!:JW TESTER REGISIRATIONAm 11Ie/00IRW 4105.I/M.7/10