HomeMy WebLinkAboutRMISC2018-4570 VI OEC 0- 2018 v0 DATE OF ISSUAVvNCE:
r e N A s'd �1� PERMIT#: I y' 1+ O
BUILDING PERMIT APPLICATION
PLEASE PRINT
OBADDRESS: 1=2143rI SUITE #
LOT: BLOCK: SUBDIVISION:
BUILDING CONTRACTOR(company name):
CURRENT MAILING ADDRESS:
CITY/STATE/ZIP: PH: # Fax#
PROPERTY OWNER: n^j5P ChoVIL�7
CURRENT MAILING ADDRESS: `�� • `1
CITY/STATE/ZIP: -Q U2C�i 1 Il M X ��(nns 1 PHONE NUMBER:/ �j 115 55 G L4+---
PROJECT VALUE: $ Qp.p G FIRE SPRINKLERED? YES NO A'
DESCRIPTION OF WORK TO BE DONE:
USE OF BUILDING OR STRUCTURE: S`G1'.P1 G
NAME OF BUSINESS:—TI1l\JCf91 Cil7 G 11.f Pj G (� {STt'i S t v
** Total Square Footage under roof: Square Footage of alteration/addition:_ d 5�
❑ I hereby certify that plans have been reviewed and the building will be inspected by a certified energy code inspector in accordance with
State Law. Plan review and inspection documentation shall be made available to the Building Department(required for new buildings,
alterations and additions)
❑ I hereby certify that plans have been submitted to the Texas Department of Licensing and Regulation for Accessibility Review.
Control Number: (Not required for I&2 family dwellings)
**FOR DEMOLITIONS,ADDITIONS AND OR ALTERATION TO COMMERCIAL AND PUBLIC BUILDINGS*
❑ 1 hereby certify that an asbestos survey has been conducted for this structure in accordance with the regulatory requirements of the Texas
Department of Health.
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. 1 FURTHERMORE UNDERSTAND
THAT PLANS AND SPECIFICATIONS ARE NOT REVIEWED FOR HANDICAPPED ACCESSIBILITY BY THE CITY,AND THAT THE
DESIGN PROFESSIONAL/OWNER IS RESPONSIBLE FOR OBTAINING SUCH APPROVAL FROM THE APPROPRIATE STATE AND
OR FEDERAL AGENCY(S).
PRINT NAME: hS'NfAll I GJSSEl SIGNATURE:
PHONE#: 1 rl'L}? 1' IZ 15 FAX#: Ix 11 -L)AI 9 45
THE FOLLOWING IS TO BE COMPLETED BY THE BUILDING INSPECTION DEPARTMENT
Construction T e: V Permit Valuation: $ Q DO •oo Setbacks A roval to Issue
Occu anc Grou V Front: — Electrical
Division: Buildin Width: I D t Left: — Plumbin —
Zonin 12 M H Buildin De the g I Right: Mechanical—
Rear:
Plan Review A roval: Date: 12.1 L1. 1 Sl Water Availability Rate: -'
Site Plan A roval: Date: Sewer Availability Rate:
Fire D artment: Date: Building Permit Fee:
Public Works De artment: Date: Plan Review Fee:
Health De artment: Date: Lot Drainage Fee:
Approved for Permit: Date: 12.1M-1'1( Total Fees:
Lot Drainage Submitted: Approved: Total Amount Due:
P.O.BOX 95104,GRAPEVINE,TX 76099 (817)4I0-3165 6:F0rms\Bl11LDING.APP--1/2i02--Rev.l 1/19/04,5/23/06,2/16/07
ALL CHANGES FASQUIRE
APPROUAL I OF REVISED PLANS I
APPROVE' rCANS SHALL BE
KEPT ON JOBS!TE ATALL TIMES
2
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Ct-r.!TISACTO SHALL CALL FOR
INS',' -(MON&
P1 7) 41 0-301 ® �
CONTRACT R REGISTRATION
WILL BE R VOKED UPON I
PEFMCI F EXPIRATION, sl
CITE' OEGf' EVINE
R�=�tA` ED FCaCi_iCNSTRUC iON
SHEET:_ _ _ OF:
RELEASED-)ESNOT^U'iHORIZEANYW RKIN
CONFLICT Vvi'H " 3!J'' DING CODE OR ZONIN ORDINANCE.
CITY A_ PP; IV -D P!_/\NS TO BE EPT ON
DB �. i�.E A ALL TIM S
DATE: I _ ��1 'ZV)Sf BY: d^c_0
BU .OING INSPECTION DIVISION: 1
REI i_-E D( S NOT APPLY TO CONSTRUCT-ON IN 1 t.1 (1 1
'ASE JS OR PI IBLIC RIGHT-OF-WAY \.O 10
AL- APPROVE0
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Size: 30ncm 229cm 195cm
Door 141cm 165
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