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Home My WebLink AboutPLBG2019-1122 .�1 � F � WMECHANICAL Issue Date: CITY OF GRAPEVINE(CIRCLE ONE) - ELECTRICAL - PLUMBING - IRRIGATION - FUEL GAS PERMIT APPLICATION (PLEASE PRINT LEGIBLY-COMPLETE ENTIRE FORM PERMIT# BLDG.PERMIT# DATE: JOB ADDRESS 3iI 0G SUITE# DESCRIPTION OF WORK: rz (4ce ex,'sfn ML btic �/ efav,'�r �f s ru\ r�cgc PROPERTY OWN R: CONTRACTING JCOM ANY: q to re rs /��S S2/Y 6 ADDRESS:3600 ADDRESS: JJ ��ve v,>,<a.t�lc @ac-� � c - 9 /Y( CITYISTATEIZIP: CITYISTATEIZIP:,y rci CV,i� 7 �"�� /[ jjI�ta vCT3Z 160( PHONE NUMBER: PHONE NUMBER:, �Sy k TYPE OF OCCUPANCY BUILDING AREA PERMIT FEES AMOUNT DUE SQ FT EACHTRADE 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 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 100001+ $ 582.00+ .003 f 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 ,rife / 50,001-100,000 $ 127.00+ .007 PER CCJ $ ` 'o U y 100,001-500,000 $ 327.00+ .005 DOLLAR $ 500,001+ $ 1,327.00+ .003 IVALUATI ON V. MISCELLANEOUS EACH TRADE IRRIGATION SYSTEMS. $ 37.00 j (•`�j MOBILE HOME SERVICE $ 37.00 TEMPORARY POLE SERVICE $ 37.00 SWIMMING POOLS $ 37.00 SIGN ELECTRIC $ 37.00 $ C:\Users\sbatleVWpData\Local\Microsoft\Windo kTemporary Internet Files\Content.Outlaok\G8OE6GQRMEP APPLICATION 4-1 i.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 VERIFIC TION OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT PRINTED NAME (OR HOMEOWNER FOR HOMEOWNERS PERMITS) / �� PHONE#: �S 7 S(2 0-e 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.grapevinetexas.gov C:\Users\sbatleWppData\Local\Microsofl\Window Tempomry Internet Files\Ccrnent,OuVO k\G80E6GQRMEP APPLICATION 4-1 Tdoc PLUMBING PERMIT (VALUE) Sf'1.1 A T7 M1J].R'P� Issue Date:March 27,2019 `�,* E. R 1 %tea PROJECT DESCRIPTION:Replace Existing RPZ Backflow Device at Syrup Rack"Panda Express" PROJECT# (817)410-3010 Www.mygov.us PLBG-19-1122 Inspections Permits City of Grapevine LOCATION TENANT LEGAL P.O.Box 3000 Grapevine Mills Pkwy. Panda Express Inc Grapevine Mills Addition Blk 1 TX Grapevine,,TX 76099 Suite#FC9 Lot 1r3 (817)410-3165 Voice Grapevine,TX 76051 Panda Express Inc (817)410-3012 Fax CONTRACTOR INFORMATION All Assembly Backflow LLC(PLBG) County Tarrant State ID#41362 Square Footage 5303 Holly Trail VALUATION 1000 Arlington,TX 76016 (254)592-1208 Phone Zoning CC-Community Commercial FEES TOTAL=$45.00 OWNER Plumbing Permit Fee(VALUE) $45.00 Grapevine Mills Mall LID PAYMENTS TOTAL=$45.00 225 W Washington St Indianapolis, IN 46204-6120 All Assembly Backflow LLC(PLBG)(Moses ph. (317)636-1600 Kemp) 00($45. Other on 0312712019 ) AVAILABLE INSPECTIONS Note:CC2790 Backflow Device Inspection(required) NOTICES TCEQ Backflow Certification Submit ALL work must be done in compliance with the 2006 INTERNATIONAL (required) PLUMBING CODE. � Plumbing Final(required) 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. 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. 1-a-7-� ? MYGOV.Us City of Grapevine PLUMBING PERMIT(VALUE)I PLBG-19-1122 I Printed 03127/19 at 1:29 p.m. Page 1 of 3 tI1A� �� Zpjti CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE ANNUAL TEST IRRIGATION PWS I.D.# 2200013 OTHER Ar-r I,t4 NAME OF BUSINESS WHERE DEVICE IS LOCATED: �^�� 'XI�'7LSS �� G�'�neV n A"16- ADDRESS OF SITE SERVICED: cov ur;r>r C. m '!I f:7K w> #f yL _ &r�f„ v . c y;k i &OS PLUMBING PERMIT IF APPLICABLE: # f q - i / �-D / TESTER LICENSE NUMBER: is "F�(�7/ 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: !V,: ('t-T SIZE: MODEL: L f C=Q SERIAL NUMBER: PHYSICAL LOCATION OF METER: C>>� S y- `^,-' r c c K REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER DOUBLE CHECK VALVE AIR INLET CHECK VALVE ASSEMBLY 1'CHECK 2ND CHECK RELIEF VALVE DC-Cloyed Tight Closed Tight Open at_psid _psid Initial j�RP /--psid '�L—� Opened at J Did not open Leaked Test 7 L)Leaked Leaked psid Repair Materials Used Test DC-Closed Tight Opened at Opened at After Closed Tight _psid Repair _RP_ psid psid psid The above is certified to be true. TESTERS FIRM NAME: ��'�: f��..:y''y'✓ �. �� ADDRESS: ��-S`i �u,.cwT>I CITYISTATE21P: rJ,' t� -rkU' ( � 5� ��'� DATE: 4 " -') G� '- � PHONE NUMBER: PRINT NAME: I' '�" I��I? SIGNATURE: DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT(81 7)410-3010 CW'LUME-tlN neLCCpLSt\TemO%R9ry'MSe\TLC-0M4 OWTESTER REGIS TM rbc it3+N .R 4 1..,0