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Home My WebLink AboutCO2019-2044 UNDER CONSTRUCTION CORRECTION LETTER PW OR LD NEEDED TD NO LETTER WAITING FIRE HOLD CODE C/O CHECK LIST C/O PERMIT# P19 - ADDRESS: Eli BUSINESS NAME: I BUSINESS!PROPERTY _1 CHANGE NAME / OWNER NEW CONST/ADDITION PERMIT# L,-�NEW TENANT/ OCCUPANT REMODEL/ALTERATION PERMIT# ISSUE DATE FINAL DATE 1, APPLICATION FORM COMPLETED ---'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 5. ZONING CHECKED &COMPLETED ON APPLICATION 6. BUILDING INSPECTION SCHEDULED DATE lfG 19 TIME b 7. FIRE DEPT, INSPECTION SCHEDULED DATE t0 TIME /: 30 FIRE INSPECTOR: 1nq1 - 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 / NO 14. FIRE DEPARTMENTS SIGN OFF LETTER: YES / NO 15. HEALTH DEPARTMENT SIGN OFF 16. CITY SECRETARY(Alcohol License Sign Off) —17. PUBLIC WORKS SIGN OFF —. /18. LOT DRAINAGE SIGN OFF 19. LANDSCAPING SIGN OFF '?`ry 20. BUILDING OFFICIALS SIGNATURE 21. C/O CERTIFICATE ISSUED ELECTRIC RELEASED: SCAN CERTIFICATE TO MYGOV: _ CONDITIONS TO BE TYPED ON C/O? YES/NO MAILED: 0:1FORMSIDSCOINFOR MATIONiCKL IST 121301041 R-A 1111,1 1115,5118 DATE OF ISSUANCE: _GRARUM. T F • r i s PERMIT#• MAY 2 2 2019 CERTIFICATE OF OCCUPANCY REQUEST FEE: $50.00 NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCYIS ASSOCIATED WITH ANACTI PE CURRENT BUILDING PERMIT ADDRESS OF OCCUPANCY: 4811 Merlot Avenue SUITE# 110 LOT:— 2R1 BLOCK: 2 SUBDIVISION: Delaney Vineyards Addition ****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOUT LEGAL DESCRIPTION**** NAME OF BUSINESS: Custom Care Healthcare, Inc. d/b/a Custom Care Home Health NEW OCCUPANT: YES x NO_ _ NEW BUILDING/PROPERTY OWNER: YES NO x NEW BUILDING: YES NO_x_ NEW BUSINESS NAME CHANGE: YES NO x NUMBER OF EMPLOYEES: j I FREIGHT FORWARDING: YES NO x NEW BUSINESS OWNER: YES NO x TYPE OF BUSINESS: Home Health Care _ SQUARE FOOTAGE: 7,346 (Example:Retail Clothing/Attorney's Office/Office-Warehouse/Restaurant) NAME OF TENANT [PERSONS NAME]: Thomas Gleason CURRENT MAILING ADDRESS: 4811 Merlot Avenue, Suite 110 CITY/STATE/ZIP: _ Grapevine TX 76051 PHONE NUMBER: 972-242-5959 PROPERTY OWNER: Merlot Court, L.P. c/o Richfield Homes MAILING ADDRESS: 428 Kimbark Street CITY/STATE/ZIP: Lon4umont CO 80501 PHONE NUMBER: 303-955-2493 # IS YOUR BUSINESS SUBJECT TO SALES TAX LAW?(if yes,provide copy of Sales Tax Certificate)---- YES NO x # WILL THERE BE ALCOHOLIC BEVERAGE SALES?(if yes,provide copy of Alcoholic Beverage Permit)-YES NO x # PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED?------------------- YES_x_NO # WILL BUSINESS GENERATE ANY INDUSTRIAL WASTE DISCHARGE TO SEWER SYSTEM?------YES NO x # WILL OUTSIDE REFUSE/RECYCLING/COMPACTING CONTAINERS BE NECESSARY? (if yes,screening is required)----------------------------------------------------------- YES NO x # WILL THERE BE ANY OUTSIDE STORAGE(including storage of company/fleet vehicles),DISPLAY, USE OR DINING?------------------------------------------------------------------ YES NO_x_ # WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING?------------------------- YES NO x # IS BUILDING SPRINKLERED?------------------------------------------------------- YES NO x # WILL BUSINESS STORE OR HANDLE HAZARDOUS MATERIALS OR LIQUIDS? (if yes,provide list of types&quantities,along with material safety data sheets)----------------------YES NO x 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 PLEASE CALL(817)410-3165. s SIGNATURE: PRINT NAME: Elliot McMillan PHONE#: (208) 401-1359 EMAIL: (OVER) Development Services Department The City of Grapevine*P.O.Box 95104 * Grapevine,Texas 76099 * (817)410-3165 Fax(817)410-3012* www.;rai evinetexas. ov O:FORMSIDSAPPLICATIO NSIC/ 312212001/Rev:5106,2/07,4/09,2/13,11/15,10/16,6/19 TEXAS SALES TAX 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 of 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 WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED? ADDRESS: 4811 Merlot Avenue, Suite 110 CITY, STATE, ZIP• Grapevine TX 76051 * :� �r >•< FOR OFFICE USE TYPE OF CONSTRUCTION;. OCCUPANCY: DIVISION: ZONING DISTRICT: CONDITIONAL USE: PERMITTED USE: BUILDING DEPARTMENT- DATE: BUILDING INSPECTOR: DATE: ZONING APPROVAL: DATE: FIRE DEPARTMENT: . DATE: LOT DRAINAGE INSPECTION: DATE: PUBLIC WORKS DEPARTMENT: DATE: HEALTH DEPARTMENT: DATE: CITY SECRETARY: DATE: rr LANDSCAPING APPROVAL: s DATE: APPROVAL FOR ISSUANCE• DATE: O:FORMSIDSAPP LICATIONSIC/ 3122/2001/Rev:5/06,2107,4109,2113,11115,10116,8/18 CERTIFICATE OF OCCUPANCY r Issue Date:June 7,2019 PROJECT DESCRIPTION:C/O(Home Health Care)"Custom Care Healthcare Inc.dba Custom Care Home Health"[sub-leasing inside same suite as Custom Care Hospice] PROJECT# (817)410-3010 WWW.mygov.us CO-19-2044 Inspections Permits City of Grapevine P.O.Box 95104 LOCATION TENANT LEGAL Grapevine,TX 76099 4811 Merlot Ave. Custom Care Healthcare Inc. Delaney Vineyards Addition (817)410-3165 Voice Suite#110 dba Custom Care Home Blk 2 Lot 2r1 (817)410-3012 Fax Grapevine,TX 76051 Health Keystone Hospice Care,Inc. dba, Custom Care Hospice CONTRACTOR INFORMATION Elliott McMillan *CONSTRUCTION TYPE VB 4811 Merlot Ave. *OCCUPANCY GROUP B Grapevine,TX 76051 *ZONING DISTRICT PO (208)401-1359 Phone '' NAME OF BUSINESS Custom Care Healthcare, Inc.dba Custom Care Home Health OWNER **TYPE OF BUSINESS Home Health Care Merlot Court Lp **APPLICANT NAME Elliott McMillan 428 Kimbark St 1 **APPLICANT PHONE NUMBER 2084011359 Longmont, CO 80501 **TENANT NAME Thomas Gleason ph. (817)637-8000 **TENANT PHONE NUMBER 9722425959 AVAILABLE INSPECTIONS *Sales Tax NO ► Final Building C/O Inspection(required) *Sales Tax Number ► Final Fire Dept Inspection(required) Alcoholic Beverage Sales NO ► Landscaping(required) ► C/O APPROVED FOR ISSUANCE Alterations NO (required) Change of Business Name NO Change of Business Owner NO County Tarrant Fire Sprinkler System? NO 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 11 Outside Refuse/Recycling NO Outside Storage NO Signs YES Square Footage 7346 Zoning PO-Professional Office FEES TOTAL=$50.00 Certificate of Occupancy $50.00 Ll us OtELENGE1 -T, NORMAN RAT I-J ftCT UP ON UNOHXO'd OVIDOXOU CL 74 T. is%," j.-NB-ENTER GLADE— 3AV3.tVIGNVYllJM lb TZVHS-S� KA vw- ' CERTIFICATE OF OCCUPANCY WORKORDER PERMIT# 19 - -1 ADDRESS OF INSPECTION: ` l� o ")]e I DATE OF INSPECTION• o P(f In TIME OF INSPECTION: I. 3O NAME OF BUSINESS: - /h Oar, 4A �I ,% �,.y TYPE OF BUSINESS: USE OF BUILDING AND/OR PREMISES: REASON FOR APPLYING: CONTACT PERSON: �I ��I� fnl, e 1 TELEPHONE NUMBER: ) :2-�69 COMMENTS/VIOLATIONS: Ak it OL 4Ttd.a/ 7_ **TO BE FILLED OUT BY BUILDING OFFICIAL** ZONING DISTRICT OF INSPECTION LOCATION: TYPE OF BUILDING: GROUP AND DIVISION: ZONING RESTRICTIONS: 0:FORMS DSCOINFORMATION WORKORDER 12 30 04 Rev.1 17 2006 J ' 4a) (DN ! t U� a O la O �. 0 N U 1�1 C-C p N - c COC O Q LO O p c L O O GD +� 00 O O0c C _j 0OO l m Urn N co,c a) -C L U" O a c i M Cam O � E E U Y O tm 00 0 co r v ooh a � � � a �. c6 Co a _ C�y C N a � ♦� o- 4) Q V N O > � e N O ♦ ♦ d U Q N { ,r}��° x > 0 O C r- Op J d •' Ual f, Q Q. 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