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HLP2019-0287
r EVINE r'T E X. it S January 17, 2019 The attached application is for a Helicopter Lift Request. Please sign the attached memo and forward packet to the City Manager's Office. Once City Manager has signed please return to Connie Cook, Development Services. Location: 3000 Grapevine Mills Pkwy. #525, January 24, 2019 at 7:30 a.m. With Rain Dates of January 29th, January 30th and January 31, 2019. Melanie Hill, Risk Manager Bruno Rumbelow, City Manager Thank you, Connie Cook Development Services (817) 410-3158 Permit will not be issued until FAA Approval has been received. MEMORANDUM CITY OF GRAPEVINE. TEXAS TO: BRUNO RUMBELOW, CITY MANAGER MELANIE HILL, RISK MANAGER FROM: SCOTT WILLIAMS, DEVELOPMENT SERVICES DIRECTOR/ BUILDING OFFICIAL SUBJECT: HELICOPTER LIFT REQUEST DATE: JANUARY 17, 2019 Attached is a request for a helicopter lift scheduled for January 24, 2019 at 7:30 a.m. With Rain Dates of January 29th, January 30th and January 31, 2019 for 3000 Grapevine Mills Parkway#525, if it meets your approval, please sign below: City Manager Risk Manager Development Services Director OACCook\HelicopterMemorandum HELICOPTER LIFT PERMIT GRA E,i�� � � Issue Date:January 22,2019 PROJECT DESCRIPTION:Helicopter Lift-January 24,2019 with Raindates of January 29th,30th&31st @7:30 a.m."Sea Life" PROJECT# (817)410-3010 www.mygov.us Hl l_P-19-0287 Inspections Permits City of Grapevine P.O.Box 95104 LOCATION TENANT LEGAL Grapevine,TX 76099 3000 Grapevine Mills Pkwy. Sea Life Center Aquarium Grapevine Mills Addition Blk (817)410-3165 Voice Suite#525 1 Lot 1 r3 (817)410-3012 Fax Grapevine,TX 76051 Sea Life Center Aquarium CONTRACTOR INFORMATION 5 State Helicopter's "APPLICANT NAME Susan Bitros 285 Blackland Rd. "APPLICANT PHONE NUMBER 9726364009 Fate,TX 75189 APPROVAL CITY MANAGER YES (972)636-4009 Phone APPROVAL DEVELOPMENT SERVICES YES APPROVAL RISK MANAGEMENT YES OWNER County Tarrant Grapevine Mills Mail Lp DATE&TIME OF HELICOPTER LIFT 2019-01-24 07:30 am RAIN DATE FOR HELICOPTER LIFT 2019-01-29 07:30 am RAIN DATE FOR HELICOPTER LIFT 2019-01-31 07:30 am RAIN DATE FOR HELICOPTER LIFT 2019-01-30 07:30 am Zoning CC-Community Commercial t MECHANICAL PERMIT (VALUE) IT I } � Issue Date:January 22,2019 0 F +` t PROJECT DESCRIPTION: Replace(2)25 Ton Roof Top Units"Sea Life" � PROJECT# (817)410-3010 WWW.mygov.Us MECH-19-0278 Inspections Permits City of Grapevine LOCATION TENANT LEGAL P.O.Box 95104 3000 Grapevine Mills Pkwy. Sea Life Center Aquarium Grapevine Mills Addition Blk 1 Grapevine,TX 76099 Suite#525 Lot 1r3 (817)410-3165 Voice Grapevine,TX 76051 Sea Life Center Aquarium (817)410-3012 Fax CONTRACTOR INFORMATION Fort Worth Heat&Air Square Footage State ID#TACLA54416E VALUATION 53847 PO Box 466 - °- Fort Worth,TX 76101 FEES TOTAL=$503.93 (817)874-0920 Phone Mechanical Permit Fee(Value) $503.93 (817)336-3812 Fax (817)800-0340 Mobile PAYMENTS TOTAL=$503.93 Fort Worth Heat&Air(Greg George) OWNER Check on 0912212099 ($503.93) Note:CK5685 Grapevine Mills Mall Lp - - NOTICES 225 W Washington St ALL work must be done in compliance with the 2006 INTERNATIONAL Indianapolis, IN 46204-6120 MECHANICAL CODE. ph. (317)636-1600 AVAILABLE INSPECTIONS PLAN SUBMITTAL:WHEN PLANS ARE REQUIRED BY CODES, ► Mechanical Rough(required) ORDINANCES, OR AS DETERMINED BY THE BUILDING OFFICIAL,THREE ► Mechanical Final (required) (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. 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/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. Signature Date 285 BLACKLAND ROAD SIff TR FATE,TEXAS 75189 (972)636-4009 HELICOPTERS Congested Area Plan FAA CERT.LDUL599B DATE: January 17, 2019 Date/Time of Job: Job Site: Contractor: January 24,2019 Grapevine Mills Mall- Sea Life Fort Worth Heat and Air 07:30-10:00 3000 Grapevine Mills Pk 308 N.Beach Cable Length: Grapevine,TX 76051 Fort Worth, TX 76111 Approx. 85 Feet Contact: Greg George- 817-874-0920 Greg George-817-874-0920 There are power lines and light poles in the area,however,they will not cause a safety hazard to the lift. Plan Prepared By: Emily Webster: f��*Wk*-, Should a weather,mechanical or material delay be experienced this CAP is approved for the date and time listed above plus 10 days. **5 State Helicopters,Inc. will re-notify all contacts listed on the CAP if an extension is required** FAA:North Texas FSDO 214-277-8500 APPROVED BY: FAA STAMP: JOSE A Digitally signed by JOSE A CABRERA CA B R E RA 06:26:38 106'00 s THIS COMPANY COMPLIES WITH THE "CODE OF ETHICS:OF THE HELICOPTER ASSOCIATION OF AMERICA 3 HOLD HARMLESS AND INDEMNITY AGREEMENT PROJECT ADDRESS: Grapevine Mills Mall-Sea Life 3000 Grapevine Mills Pkwy Grapevine,TX 76051 NATURE OF OPERATION:Air lifting air conditioning units DATE OF OPERATION: 24 January 2019 with rain date of 31 January 2019 with a 10 day grace period for each date mentioned. I,Susan Bitros,the undersigned,representing 5-State Helicopters, Inc.,binding my heirs, executors, administrators,estate and assigns, do hereby agree to completely and wholly release indemnify the hold harmless the city of Grapevine,its officers,agents, independent contractors,and employees from any and all claims, damages, personal injury, including death, property damage, lawsuits and judgments, including court costs,expenses and reasonable attorney's fees,and all other expenses resulting from any and all activities conducted within the city of Grapevine,Texas. It is the understanding of all parties that this release, indemnity,and hold harmless agreement shall apply whether or not the claims, damages, harm, personal injury,including deaths,property damage, lawsuits,judgments,court costs, attorney's fees and any other expenses arise from the negligence of whatever nature, omissions,willful and intentional acts of this individual, company or company's officers,agents,employees,independent contractors,other representatives,invitee, licensee,or guests. I,the undersigned individual and/or company company's officer,certifies,warrants and represents that the individual whose signature appears below is duly authorized to execute this agreement on behalf of the firms,corporation, partnership or other entity who will operate within the city of Grapevine,Texas. In witness whereof,this agreement has been executed this J<day COMPANY:5-STATE HELICOPTER$, IN �r BY:Susan Bitros rinted C /fir Isj A .J TITLE: Manager (sign re) STATE OF c f COUNTY OF �-Z OA fd This instrument was acknowledged before me on this the a day of ftnoA, Wilr NOTARY PUBLIC IN AND FOR THE STATE OF— My commission expires_ J" r rJ� �tMrP, Sonya Lea Stovall Signat«f e _ Notary Public,State Texas y Notary ID 12965922 3-4 s ° My Commis ion Exp.12-23-2(12 k. �� -31 - - ri McGriff, Seibels & Williams, Inc. Certificate of Insurance -v Certificate No.82775 Rev.Date:Jan 31,2018 This is to certify that the policy(ies)of insurance as described below have been issued to the Insured for whom this Certificate is executed and is/are in force at this time.This Certificate is issued for information only and confers no rights upon the holder.This Certificate neither affirmatively nor negatively amends,extends or alters the coverage afforded by such policy(ies)or binder(s)stated herein.This certificate cancels and supersedes all previously issued certificates. Certificate Holder: City of Grapevine PO Box 95104 Grapevine,TX 76051 Named Insured: 5 State Helicopters,Inc. 285 Blackland Road Fate,TX 75189-4746 Policy Type: Aircraft Hull&Liability and Aviation General Liability Policy Policy Period: February 01,2018 to February 01,2019 both days at 12:01 am Local Standard Time at the address of the Named Insured shown above Insurer(s): Company Policy No(s). StarNet Insurance Company through Berkley Aviation,LLC BA-18-02-00056/BA-18-02-00055 Aircraft Covered: Sikorsky S58T,N4XY;Sikorsky S58T,N6BL Coverage&Limits Aircraft Liability Coverage Limit Combined Single Limit Bodily Injury,including Personal Injury and $10,000,000 each occurrence as respects Sikorsky S-58BT and Sikorsky Property Damage Liability(Excluding Passenger Liability) S-58ET type aircraft. Cargo Legal Liability Coverage Limit Cargo Legal Liability including Slung Loads $500,000 each occurrence,subject to a deductible of$1,000 each claim. Certificate Provisions Additional Insured It is agreed that the Certificate Holder is included as an Additional Insured under the Aircraft Liability Coverages,but only to the extent of liability vicariously imposed upon the Certificate Holder solely as the result of an act or omission of the Named Insured or its employees in connection with the Named Insured's Aircraft operations,subject to all policy terms,conditions and exclusions. Auth rized ReprcWntative 7525 SE 24th Street,Suite 520,Mercer Island,Washington 98040 Certificate No: Page 1 of 1 Phone:(206)232-9870-Fax:(206)232-9515 82775 285 BLACKLAND ROAD TATE FATE,TEXAS 75189 (972)636-4009 So HELICOPTERS Congested Area Plan FAA CERT.LDUL599B DATE: January 17, 2019 Date/Time of Job: Job Site: Contractor: �Januar7y 24,2019 Grapevine Mills Mall- Sea Life Fort Worth Heat and Air :30 0:00 3000 Grapevine Mills Pku,. 308 N. Beach Cable Length: Grapevine, TX 76051 Fort Worth, TX 76111 Approx. 85 Feet Contact: Greg George - 817-874-0920 Greg George- 817-874-0920 There are power lines and light poles in the area,however,they will not cause a safety hazard to the lift. Plan Prepared By: Emily Webster: Should a weather,mechanical or material delay be experienced this CAP is approved for the date and time listed above plus 10 days. **5 State Helicopters,Inc. will re-notify all contacts listed on the CAP if an extension is required** FAA: North Texas FSDO 214-277-8500 APPROVED BY: _ FAA STAMP: THIS COMPANY COMPLIES WITH THE "CODE OF ETHICS:OF THE HELICOPTER ASSOCIATION OF AMERICA 3 285 BLACKLAND ROAD y TAH FATE,TEXAS 75189 (972)636-4009 imam HELICOPTERS (972) January 17, 2019 Connie Cook, City of Grapevine Attention: City Manager Reference: 5 State Helicopters Landing and Operations This letter, with the location, dates, and time of a helicopter external load operation that is being flown by 5 State Helicopters,Inc. is to ensure there are no restrictions or regulations preventing the helicopter from landing within the city limits of Grapevine, Texas. Date/Time of Job: Location: Contractor: January 24, 2019 Grapevine Mills Mall Sea Life Fort Worth Heat and Air 07:30-10:00 3000 Grapevine Mills Pkwv 308 N.Beach Grapevine, TX 76051 Fort Worth, TX 76111 Helicopter Type: Sikorsky N4XY(Blue),N6BL(Red) TRANSPORT CATEGORY Pilot: Scott Ladue or Dennis Banks 5 State Helicopters, Inc. assures the City of Grapevine, Texas that it will comply with all State, Federal and local regulations,holds and required permits and is licensed to do the type of work as described in this request. 5 State Helicopters, Inc. agrees to provide a Certificate of Insurance with liability coverage of$10,000,000.00 showing the City of Grapevine as an additional insured. Please feel free to contact 5 State Helicopters with any questions and/or concerns that you may have. Office: 972-636-4009 Please sign and e-mail back to: Office @5state.com SINCERELY, APPROVED/DISAPPROVED BY_ DATE s y, IR 1P ° 0 1{ c 1 r a � ' ! 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Olt CD to 9t x l� aD CL ca 5' «ti •� C L C J p 4- C14 ti C7 M C7 ❑ O P O w � - 285 BLACKLAND ROAD FATE,TEXAS 75189 � TRTE (972)636-4009 HELICOPTERS Congested Area Plan FAA CERT.LDUL599B DATE: January 17, 2019 TO FAA OFFICE: North Texas FSDO 214-277-8500 REFERENCE: Congested Area Plan Request Date/Time of Job: Job Site: Contractor: January 24, 2019 Grapevine Mills Mall - Sea Life Fort Worth Heat and Air 07:30-10:00 3000 Grapevine Mills Pkwy 308 N. Beach Cable Length: Grapevine, TX 76051 Fort Worth, TX 76111 Approx. 85 Feet Contact: Gre€-, George- 817-874-0920 Greg George -817-874-0920 Aircraft Registration: N-6BL,N4XY Aircraft Type: S-58T Transport Category Pilots: Scott B. Ladue Commercial Certificate# 3250744 Dennis A. Banks ATP# 3369851 Hazardous Material:No Description: N/A Height of Building: 40' Load Description -Amount,Type&Weight: Helicopter Lift of 11 RTUs at 2,8201bs *If a problem or safety hazard exists the crew will contact the pilot to cease operations and move the aircraft to a safe area using two-way radios,or hand and arm signals* City of Grapevine Contacts City Manager Connie Cook Fire Darrell Brown ccook @grapevinetexas.gov, dbrown @grapevinetexas.gov sbatte @grapevinetexas.gov 817-410-4400 817-410-3155 Dispatch 972-564-7600 Police Eddie Salame esalame @grapevinetexas.gov 817-410-3204 Fire Marshall Russell Batchelor ATC Dallas Fort Worth Intl.Airport ratchelor @grapevinetexas.gov felicia.l.fuller @faa.gov, 817-410-4420 Mike.moreau @faa.gov, giovanni.dipierro @faa.gov 972-615-2605 5 Stan Helicopters 1 285 BLACKLAND ROAD FATE,TEXAS 75189 (972)636-4009 HELICOPTERS (972) Congested Area Plan FAA CERT.LDUL599B DATE: January 17, 2019 Date/Time of Job: Job Site: Contractor: January 24, 2019 Grapevine Mills Mall - Sea Life Fort Worth Heat and Air 07:30-10:00 3000 Grapevine Mills Pkwy 308 N. Beach Cable Length: Grapevine, TX 76051 Fort Worth, TX 76111 Approx. 85 Feet Contact: Greg George- 817-874-0920 Greg George- 817-874-0920 Narrative Plan of Operations: This is existing construction in a commercial area. The parking lot on the southwest side of the building will be used as the landing and emergency area. Equipment/unit staging will be in the same location, southwest parking lot. Contractor and superintendent of the job site will close the operational area to unauthorized personnel during lift operations, and the helicopter landing area will be secured prior to helicopter arrival and remain secure until the helicopter has left the landing area. Flight path from the staging area to the roof and equipment placement location will remain clear of unauthorized persons and obstacles. Lifting may be anywhere within the operational area due to the contractor and or superintendent moving the equipment prior to the helicopter's arrival. However, the flight path will remain within the operational area. Additional Information: The estimate of how many floors of the building will be penetrated if the load is released at the maximum height when lifted above the roof is none. However, for safety reasons, the building under lifting path and equipment placement will be vacant during lift operations. The pilot will remain in communication with towered airports and common traffic frequencies. Hazard Prevention: The operational area will be surveyed by 5 State Helicopters crew for safety hazards and a safety briefing will be given by 5 State Helicopters crew before lifting begins. Should a safety hazard exist, the contractor will be required to eliminate the hazard before lifting of equipment begins. 5 State Helicopters will be communicating with the pilot by radio throughout the lifting process. If for any reason, a safety factor should arise the crew will immediately notify the pilot, and the helicopter relocated to a safe area until the risk has been corrected. Emergency Landing Area: The emergency landing area/areas are plotted on the map. 5 Stag,.,Helicopters 2 285 BLACKLAND ROAD FATE,TEXAS 75189 54,16 HELICOPTERS (972)636-4009 F, Notification of Grapevine City Officials 5 State Helicopters has contacted the following city officials about the lift to be performed on January 24, 2019: 3000 Grapevine Mills Pkwy Grapevine, TX 76051 City Manager: Connie Cook Your message has been delivered to the following recipients: Subject: 5 State Helicopter Lift of HVAC Equipment 24 January 2019 in Grapevine, Texas at approximately 07:30-10:00. Police: Eddie Salame Your message has been delivered to the following recipients: Subject: 5 State Helicopter Lift of HVAC Equipment 24 January 2019 in Grapevine, Texas at approximately 07:30-10:00. Fire Chief: Darrell Brown Your message has been delivered to the following recipients: Subject: 5 State Helicopter Lift of HVAC Equipment 24 January 2019 in Grapevine, Texas at approximately 07:30-10:00. ATC: Dallas Fort Worth Intl. Airport Your message has been delivered to the following recipients: Subject: 5 State Helicopters lift operations 4 miles north of DFW. �Best Regards, (�V� 5 State Helicopters » � 2 J a 2 § � % � � ■ \ \ � % Ifd mn e ■ O 1AIZL Texas 121 Frontagn,& � . � � k Ln Lfni r > . 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