HomeMy WebLinkAboutMF2016-3125 Atdrj 1 .5 20l/ DATE OF ISSUANCE- j 2 2017,
PERMIT#:
BUILDING PERMIT APPLICATION
R-110(PLEASE PRINT LRGIBLY—COMPLIETI FN77REI'')BM)
JOB ADDRESS: IU14 f11U I JQ(1 (1} SUITE#
LOT: BLOCK: SUBDIVISION:
BUILDING CONTRACTOR
I \5(1(compa1 ny name): , O Q L
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CURRENT MAILING ADDRESS: 411D ,V i —I
CITY/STATE/ZIP: PH:# 39�
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PROPERTY OWNER: 1 P
CURRENT MAILING ADDRESS:
CITY/STATE/ZIP: ao3L,Qpa6el s —4ObS,
PHONE NUMBER: 81� -aa�3-Qga3
PROJECT VALUE: $ `1 u L0 . 6c) FIRE SPRINKLERED? YES NO
WHAT TRADES WILL BE NEEDED?(Cheekuaea that apply)ELECTRIC, PLUMBING,_ MECHANICAL_
DESCRIPTION OF WORK TO BE DONE:—& t.UO A Q Ly-,�!
USE OF BUILDING OR STRUCTURE:
NAME OF BUSINESS:
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/OWNER IS RESPONSIBLE FOR OBTAINING SUCH APPROVAL FROM THE APPROPRIATE STATE AND
OR FEDERAL AGENNCCY(S). �,.,
PRINT NAME:� Jkepha i e t nal"�) GNATURE
PHONE#: R Ll-(D G 1 -13(n(o EMAIL: N!MAIL
CHECK BOX IF PREFERRED TO BE CONTACTED BY
THE FOLLO WING IS TO BE COMPLETED BY THE BUILDING INSPECTION DEPARTMENT
Construction T \113 Permit Valuation: $ Ci U1•oo Setbacks A royal to Issue
Occu anc Grou Fire Sprinkler: YES= NO= Front: Electrical
Division: Building Depth: — Left: — Plumbin —
Zonin 5- 0 Building Width: — Rear: Mechanical —
Occu anc Load: 13;-Lt.
Plan Review A —val: Date: %I 1 17 Buildin Permit Fee: —
Site Plan A royal: Date: Plan Review Fee:
Fire De artment: Date: Lot Draina e Fee:
Public Works De artment: Date: Sewer Availabilit Rate:
Health De artment: Date: Water Availabilit Rate:
Approved for Perm it: Date: $ -Q1-1'7 Total Fees:
Lot Drainage Submitted: Approved:PP Total Amount Due:
P O.EO%951N,GAAPE INE,111.0 9(817)<108165
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