Loading...
HomeMy WebLinkAboutCO2019-0190 UNDER CONSTRUCTION V CORRECTION LETTER PW OR LID NEEDED_ TO NO LETTER WAITING FIRE_ HOLD_ CODE C/O CHECK LIST C/O PERMIT # P19 - U/a(-) ADDRESS: le '/-/C BUSINESS NAME: /1�i BUSINESS PROPERTY CHANGE NAME / OWNER NEW CONST/ADDITION PERMIT# NEW TENANT/OCCUPANT _REMODEL/AA ALT2ER(n,A`T1ION PERMIT�j#/� ISSUE DA�E'� '" "" `O�'�INAL DATE �1. APPLICATION FORM COMPLETE 2. ZONING MAP COPIED &WORKORDER FORM COMPLETED 3. HAZARDOUS MATERIAL SAFETY DATA SHEETS TO FIRE DATE (SCAN TO C/O IN MYGOV-IF LARGE SET,ALSO SCAN TO LF&FORWARD SET TO FIRE) 4. FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATE 1---'5. ZONING CHECKED & COMPLETED ON APPLICATION ✓6. BUILDING INSPECTION SCHEDULED DATE �Id9 TIME /Ix- 7. _ FIRE DEPT. INSPECTION SCHEDULED DATEYTIME an )9:649 FIRE INSPECTOR: �. 8. CITY SECRETARY(ALCOHOL) NOTIFICATION DATE: 9. HEALTH INSPECTION NOTIFICATION DATE: 10. PUBLIC WORKS INSPECTION E-MAIL DATE 11. LOT DRAINAGE INSPECTION E-MAIL DATE 12. CORRECTION LETTER SENT DATE – 13. BUILDING INSPECTORS SIGN OFF LETTER: YES / NQ y 14. FIRE DEPARTMENTS SIGN OFF LETTER: YES NO 15. HEALTH DEPARTMENT SIGN OFF L) rYl 16. CITY SECRETARY(Alcohol License Sign Off) 17. PUBLIC WORKS SIGN OFF LOT DRAINAGE SIGN OFF '� 19. �_ A SDN LAPIN___ G SIGN OFF ✓ 20. BUILDING OFFICIALS SIGNATURE 21. C/O CERTIFICATE ISSUED ELECTRIC RELEASED: SCAN CERTIFICATE TO MYGOV: * CONDITIONS TO BE TYPED ON C/O? YES I NO MAILED: O'1 FORMSIDSCONFORWTIOMCK 15T I 0/041 R-11111,11 M,611 B DATE OF ISSUANCE: r-Lk l JAN 15 2019 GIB VINE. -T E a A S PERMIT#: /,?-y 19 L) Tj CERTIFICATE OF OCCUPANCY REQUEST FEE: $50.00 NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITH ANACTIVE CURRENT BUILDING PERMIT ADDRESS OF OCCUPANCY: 1040 Texan Trail SUITE# 100 LOT: LOT 3R2 BLOCK: 4 SUBDIVISION: Grapevine Station ****CERTIFICATE OF OCCUPANCY WH.L.NOT�E ISSUED WITHOUT LEGAL DESCRIPTION**** NAME OF BUSINESS: 1g1,7i�/ lCirG_'a NEW OCCUPANT: YES X—NO' NEW BUILDING/PROPERTYOWNER: YES ' NO NEW BUILDING: YES X NO NEW BUSINESS NAME CHANGE: YES NO NUMBER OF EMPLOYEES: 195-20 FREIGHT FORWARDING: YES NO ✓ NEW BUSINESS OWNER: YES NO ✓ TYPE OF BUSINESS: meted I CCc I 0 Ft ).ct, SQUARE FOOTAGE: 3-Sq 4 SF' (Example:Retail Clothing/Attorney's Office/ice-Warehouse/Restaurant) NAME OF TENANT [PERSON'S NAnIE1: _F aS Qt-66L i I-SS0 G FP C CURRENT MAILINGS/ADDRESS: 6)(n D n hl• Len Ira I 6W rP c 1,hA I Syr (G I 00 CITY/STATE/ZH': UJdWa s I T X -1-52"31 PHONE NUMBER: W)_ - I _10to-04 32 PROPERTY OWNER: TEA G,cL(coin rpS-� {-S I I J MAILING ADDRESS: (0 0(7 GCYI IYA ( XtOY� SSW l 1 ie I n D t� CITYlSTATE/ZIP: _-C&L I IT PHONE NUMBER: O 1 1-3}jLj -'08 LF `L. * IS YOUR BUSINESS SUBJECT TO SALES TAX LAW?(if yes,provide copy of Sales Tax Certificate)---- YES_NO v * WILL THERE BE ALCOHOLIC BEVERAGE SALES?(if yes,provide copy of Alcoholic Beverage Permit)-YES NO Uf� * PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED?------------------- YES ✓ NO_ * WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM? ------YES_NO * WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY? (if yes,screening is required)--------- ---------------------------- YES_NO✓ * WILL THERE BE ANY OUTSIDE STORAGE(including storage of company/fleet vehicles),DISPLAY, USE OR DINING?---------------------------------------- -- ------------------------ YES—NO * WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING?- ------------------------ YES NO_ * IS BUILDING SPRINKLERED?------------------------ YES NO * WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS? (if yes,provide list of types&quantities,along with material safety data sheets)----------------------YES—NO �! I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF MY KNOWLEDGE AND THE SAID OCCUPANCY IS IN CONFORMANCE WITH THE INFORMATION HEREIN SET FORTH. (If access to the building/space is not provided at the time of the scheduled inspection,a$42.00 re-inspection fee will be charged) FOR QUESTIONS P EASE CAL (817)410-3165. SIGNATURE:0"L4 nib{ , PRINT NAME: DA' (�w r✓ PHONE#: 11- 3 ' ©(i le 2 EMAIL: (OVER1 Development Services Department The City of Grapevine*P.O.Box 95104* Grapevine,Texas 76099 *(817)410-3165 Fax(817)410-3012 * www.erapevinctexas.gov O:FORMStDSAPPLICATIONSC/ V2=001/Rev:W6,21 A109,�3,11A5,1M6,&19 TEXASSALESTAX Texas Sales Tax is charged and collected on sales within the State and City of Grapevine,Texas of`taxable items."Taxable items include both tangible personal property,specified services. If you are in a business that will be selling"taxable items" within the City of Grapevine,Texas you will be required to collect State and Local Sales Tax in the amount of 8.25%. A"Seller or Retailer"means a person engaged in the business or making sales of`taxable items",the receipts from which are included in the measure of sales or use tax. The term,"place of business"includes any location at which three or more orders are received by the"Seller or Retailer in a calendar year.If an order is received at the place of business of a retailer in Texas,but delivery or shipment is made from a location within the state other than the retailer's place of business. State and local sales tax is due and is allocated to the city where the order was received. I have read the above and I understand that I will be required to provide a copy of the Sales Tax Permit to the City of Grapevine,Texas if the circumstance applies to my business. Texas Sales Tax Number: Signature: WHERE DO YOU N1 ANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED? ADDRESS: q(o o o ". Lt^yi-L- 1 N X rP c w,-At (Su,j-eJ 100 CITY,STATE,ZIP: Q��T� K —7,5231 * s: � * `x, *max *xFOR OFFICE USE TYPE OF CONSTRUCTION: Y'13 5t*"AV*f OCCUPANCY: DIVISION: ZONING DISTRICT: CONDITIONAL USE: ✓s-/W PERMITTED USE: 5 BUILDING DEPARTMENT: DATE: BUILDING INSPECTOR: DATE: -1 l ZONING APPROVAL: DATE: 1 FIRE DEPARTMENT: Wi 410a l/J I t LiXe I' lAA.L�IY l!Th� �. DATE: LOT DRAINAGE INSPECTION: DATE: PUBLIC WORKS DEPARTMENT: DATE: HEALTH DEPARTMENT: DATE: /,' CITY"SECRETARY": ;, DATE: LANDSCAPING APPROV ' DATE: APPROVAL FOR ISSUAN DATE: 4111--le, e, -/ l OTORMS SAMLICATIONMU 3122MD1/Re :S/06,2U]pN9,?/13,11/i5,10/I6,618 CERTIFICATE OF OCCUPANCY � *-} 1` Issue Date:April 4,2019 PROJECT DESCRIPTION:C/O[Medical Office]"Texas Retina Associates"[BLDG 19.0045] PROJECT# (817) 410-3010 www.mygov.us � CO-19-0190 Inspections Permits City of Grapevine LOCATION TENANT LEGAL P.O.Box ,TX 76099 p 1040 Texan Trl. Texas Retina Associates Grapevine Station Blk 4 Lot Grapevine,TX Suite# 100 3r2 (817)410-3165 Voice Grapevine,TX 76051 Texas Retina Associates (817)410-3012 Fax CONTRACTOR INFORMATION Dani Carr *CONSTRUCTION TYPE VB Sprinklered 1040 Texan Trl., Ste.#100 *OCCUPANCY GROUP B Grapevine,TX 76051 *ZONING DISTRICT CC (817)334-0862 Phone ** NAME OF BUSINESS Texas Retina Associates OWNER **TYPE OF BUSINESS Medical Office Tra Grapevine Property Investm **APPLICANT NAME Dani Carr 9600 N Central Expwy Ste 100 **APPLICANT PHONE NUMBER 817-334-0862 Dallas, TX 75231 **TENANT NAME Texas Retina Associates AVAILABLE INSPECTIONS **TENANT PHONE NUMBER 817-706-0432 • Final Building C/O Inspection(required) *Sales Tax NO • Final Fire Dept Inspection (required) Sales Tax Number Landscaping (required) C/O APPROVED FOR ISSUANCE Alcoholic Beverage Sales NO (required) Alterations YES Change of Business Name NO Change of Business Owner NO County Tarrant Fire Sprinkler System? YES Freight Forwarding Business NO Hazardous Material NO Industrial Waste NO New Building/Addition NO New Building or Property Owner NO New Occupant/Tenant YES Number of Employees 20 Outside Refuse/Recycling NO Outside Storage NO Signs YES Square Footage 3984 Zoning CC-Community Commercial READ AND SIGN I HEREBY CERTIFY THAT THE FOREGOING IS CORRECT TO THE BEST OF MY KNOWLEDGE AND THE SAID OCCUPANCY IS IN CONFORMANCE WITH THE INFORMATION HEREIN SET FORTH. Ix Ix sN SI ICLRD- IN, Vo CERTIFICATE OF OCCUPANCY WORKORDER PERMIT # 19 - Ol qq _) ADDRESS OF INSPECTION: x� G/U DATE OF INSPECTION: 3 j,����0!9 TIME OF INSPECTION: alY+ NAME OF BUSINESS: � 2x e✓ l %r1Qc,e/o � TYPE OF BUSINESS: ✓ � ��� USE OF BUILDING AND/OR PREMISES: REASON FOR APPLYING: /�?. O / D CONTACT PERSON: Z4", ( rum TELEPHONE NUMBER: S//7- COMMENTSNIOLATION�S:1 **TO BE FILLED OUT BY BUILDING OFFICIAL** ZONING DISTRICT OF'INSPECTION LOCATION: TYPE OF BUILDING: 1/-Z�3 GROUP AND DIVISION: / ZONING RESTRICTIONS: o.insetsowOINFORouMNwoO KOwER 12?o WR,, ;1-2000 (D dm °�� / v a j `�° om in o co c U L p N D o a o� c ¢a m o x c W v 'o m m a r> 1 c � c 3 0) >. a U X F- 4) 4 mz o o c mn mac d (7 o m _ O o V c �m0 im X14 IL L c �Q O O w U \ C V d U O- O {-�y �Cc 0 O N U � d x c 7 000 C U U E O S LV T O- o o F _w �. i Q pJ a. V 7 N N0 U = C c O D C yC m 5x r N U E N00= U W vi m rn at:i V NNN � U i NUNc ;� ' 3 L >am p £ {!J N c co mn G cTiOmS U � ID "16 fA co CLO- mn mD CD e d 0 U N N N = Q — fl OEM= F i' ) 7 C C C O. N J N aCL U m '� (6 O =O T U ! m x r C cc iE s O(`L C C X V " C U0 L- m La d N O L O O U N + i a �