HomeMy WebLinkAboutSFRA2018-0468 �+V� DATE OF ISSUANCE:
FEB 2 1 208
E@ 1 201!1 PERMIT#:
\\ BUILDING PERMIT APPLICATION
(PLEASE PRINT LEGIBLY-COMPLETE ENTIRE FORM)
JOB ADDRESS: 19 D 3 S ,-rl e- 2,jqo, Ill SUITE#
LOT: BLOCK: SUBDIVISION:
BUILDING CON\TTRAC T OR (company name): I n C l A
CURRENT MAILING ADDRESS:
CITY/STATE/ZIP: (
:—T_ C_ N, i_ :#
PROPER'L'Y OWNER: _ �M V, So lt)
CURRENT MAILING ADDRESS: r4 d I( Lam,
CITY/STATEJZIP: C6� dAAN T,�7(� V PHONE NUMBER:
PROJECT VALUE: $-3- -y 3 j8 FIRE SPRINKLERED? YES NO
WHAT TRADES WILL BE NEEDED? (Check ones that apply)ELECTRIC_ PLUMBING_ MECHANICAL_
DESCRIPTION OF WORK TO BE DONE: .1y
I /i/!�n nLyy 91p�7rly tF
USE OF BUILDING OR STRUCTURE:
NAME OF BUSINESS:
Total Square Footage ender ronf: Square Footage of alteration/additintt:
❑ I hereby certify that plans have been reviewed and the building will be impeded a certified en
Pected y energy code inspector in accordance with
State Law. Plan review all,u75pea.tio1 nocuuneutnu0or fihali be made available to the Building Depai uueut(required for new bull'w'ug5,
alterations and additions)
❑ f hereby certify that olans have been submitted to the Texas Department of Licensing and Regulation for Accessibility Review.
Control Number: (Not required for I &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)
1 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 PROFESSIONALIOWNER IS RESPONSIBLE FOR OBTAINING SUCH APPROVAL FROM THE APPROPRIATE STATE AND
GR F;?,DE:.AL AGE,':CIto).
PRINT NAME: L !/G4 SIGNAT�U /rRE
PHONE#: Q�7' 3(a 3d'— EMAIL:
L7 CHECK BOX IF PREFERRED TO
THE FOLLOWING IS TO BE COMPLETED BY TILE BUILDING INSPECTION DEPARTMENT
Construction T V Pj Permit Valuation: $ �, Setbacks A royal to Issue
Occupancy Ciro u Fire S nrlkler: YES_ NO
_ Front: Electrical
Division: Buildia Depth: Left: Plumbing iV
Zoning: — Ruildino,Width: Rear: Mechanical
Occupancy Load: N01.1 Wr�ide �+ Ba Ri ht:
Plan Review A royal: m ,/ Date: 7•/0- o Buildin Perrnit Fee: �S
Site Plan Approval: Date: Plan Review Fee:
Fire Department: Date: Lot Drainage Fee:
Public Works Department: Date: Sewer Availabilit Rate:
Health Department: Date: Water Availability Rate:
Approved for Permit: Date: T tai Fees:
HiEd
aS
8 0__
Lot Drainage Submitted: Approved: Total Amount Due:
P-0,WX 96IDq GRAPEVINE,TX7VX*(817)4M31% O:FORM SPERMRAPPLIOATIONS V/ o
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