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Home My WebLink AboutCO2019-2196 UNDER CONSTRUCTION CORRECTION LETTER_ PW OR LD NEEDED_ TD NO LETTER_ WAITING FIRE HOLD CODE_ C/O CHECK LIST C/O PERMIT # P19 - ADDRESS: � rr W'. .� - // X✓ c�� BUSINESS NAME: 22'2a,i ) ✓ �( BUSINESS PROPERTY HANGE NAME / OWNER NEW CONST/ADDITION PERMIT# v/CNEW TENANT/ OCCUPANT REMODEL/ALTERATION PERMIT# Jc3-.a 1 e<J �1. APPLICATION FORM COMPLETED ISSUE DATE FINAL DATE V 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 V' 5. ZONING CHECKED & COMPLETED ON APPLICATION / 6. BUILDING INSPECTION SCHEDULED DATE TIME V 7. FIRE DEPT. INSPECTION SCHEDULED DATE '7 rx? TIME �t y✓`_._ FIRE INSPECTOR: 8. CITY SECRETARY(ALCOHOL) NOTIFICATION DATE: —T 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 t/C19. LANDSCAPING SIGN OFF V, 20. BUILDING OFFICIALS SIGNATURE AUGry7 —721. C/O CERTIFICATE ISSUED ELECTRIC RELEASED: U 5 �" i`A SCAN CERTIFICATE TO MYGOV: CONDITIONS TO BE TYPED ON C/O? YES/ NO MAILED: 0 IFORMSIDSCOINFORMATIOMCKLIST 1213 010 4 1 Rev.11111.11115,5118 DATE OF ISSUANCE: AUG 2 2019 MAY 31 Z019 GFAVV71NE�T E PERMIT#: / —02 f ClI 6I cn I -)- CERTIFICATE OF OCCUPANCY REQUEST FEE: $50.00 NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCY IS ASSOCIATED WITH ANACTIVE CURRENT BUILDING PERMIT ADDRESS OF OCCUPANCY: &= kJ. //� SUITE# LOT: .3.�_ BLOCK: f 1 SUBDIVISION: awOo �p/p�d ""CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WITHOta LEGAL DESCRIPTION"" t NAME OF BUSINESS: 1/1/j�knsn �G NEW OCCUPANT: YES N6 NEW BUILDING/PROPERTY OWNER: YES NO NEW BUILDING: YES NO NEW BUSINESS NAME CHANGE: YES�_NO NUMBER OF EMPLOYEES: FREIGHT FORWARDING: YES NO— NEW / NEW BUSINESS OWNER: YES NO TYPE OF BUSINESS: / y e✓O✓Ir / I SQUARE FO TAGE: (Example:Retail Clothing/Attorn 's Office/Office-Warehouse/Restaurant NAME OF TENANT [PERSON'S NAME]: CURRENT MAILING ADDRESS: 4-0 CITY/STATE/ZIP: Fd-q� 'e 0 �S PHONE N BMu ER:('kl ¢ !r� �J 6 PROPERTY OWNER: rLL �o KGB MAILING ADDRESS: p p \ CITY/STATE/ZIP: �_T �z�� PHONENUMBE 24 l/— ♦ IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes,provide copy of Sales Tax Certificate)---- YES P NO ♦ WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes,provide copy of Alcoholic Beverage Permit)-YES_NOX ♦ PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED?------------------- yESL<,-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,4 ♦ WILL THERE BE ANY OUTSIDE STORAGE(including storage of company/fleet vehicles),DISPLAY, USE OR DINING?------------------------------------------------------------------ YES_NOX ♦ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING?------------------------- YES tS 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 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 C L(817)410-3165. SIGNATURE: 1/V` _ PRINT NAMEf/ 1 PHONE#: ��( � , — JO EMAIL: Development Services Department The City of Grapevine*P.O.Box 95104 *Grapevine,Texas 76099 (817)410-3165 Fax(817)410-3012 *www.grapevinetexas.gov O:FORMSIDSAPPLICATIONSIC/ 312V2001/Rev 5/06,21Ur,4/09.Vl3,11/15,10/16,8118 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. , 1' 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 myl business. Texas Sales Tax Number: Signature: - � WHERE DO YOU WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED? ADDRESS: CITY, STATE,ZIP: OFFICE USE TYPE OF CONSTRUCTION: OCCUPANCY: DIVISION: ZONING DISTRICT: CONDITIONAL USE: AVA a PERMITTED USE: ` rLy BUILDING DEPARTMENT: e DATE: BUILDING INSPECTOR: \ DATE: '2�- \ — 1 zi ZONING APPROVAL: DATE: �J FIRE DEPARTMENT: DATE: ' y�L/j i�5/ 2,oA/lj LOT DRAINAGE INSPECTION: DATE: ari PUBLIC WORKS DEPARTMENT: DATE: HEALTH DEPARTMENT: DATE: CITY SECRETARY: DATE: LANDSCAPING APPROVAL: V "`v W• DATE: APPROVAL FOR ISSUANCE: L?%'2 DATE: Z 7 O:FORMSIOSAPPLICATIOWC/ 312212001/R.v:5/06,2/W,4/09,2113,11/15,10116,8118 CERTIFICATE OF OCCUPANCY 1 Issue Date:August 2,2019 ~�I�P VISE -1 I] M1 s Y PROJECT DESCRIPTION:C/O[Medical Clinic]"Men's T Clinic"[BLDG 19-21891 PROJECT# (817)410-3010 Www.my9ov.us CO-19-2196 Inspections Permits City of Grapevine LOCATION TENANT LEGAL Grapevine,,T TX 76099 v"1' P.O.Box 1000 W State 114 H Men's T Clinic Hayley Addition Blk 1 Lot 3r3 X Grapevine,TX 76051 (817)410-3165 Voice (817)410-3012 Fax CONTRACTOR INFORMATION Matt Brady *CONSTRUCTION TYPE VB 1000 W.State 114 Hwy. *OCCUPANCY GROUP B Grapevine,TX 76051-0000 *ZONING DISTRICT HC (214)326-8810 Phone **NAME OF BUSINESS Matt Brady OWNER **TYPE OF BUSINESS Medical Clinic One Triple 0, LLC c/o John T. Evans Co., **APPLICANT NAME Matt Brady Inc. **APPLICANT PHONE NUMBER 214-326-8810 8350 N Central Expwy,Ste.#1300 **TENANT NAME Dallas,TX 75206 Derek Lynn Da as,T 7520 00 **TENANT PHONE NUMBER 214-447-9736 *Sales Tax NO AVAILABLE INSPECTIONS *Sales Tax Number • Final Building C/O Inspection(required) Alcoholic Beverage Sales NO • Final Fire Dept Inspection(required) • Landscaping(required) Alterations YES C/O APPROVED FOR ISSUANCE Change of Business Name NO (required) 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 4 Outside Refuse/Recycling NO Outside Storage NO Signs YES Square Footage 1602 Zoning HC-Highway 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. MYGOV.US City of Grapevine I CERTIFICATE OF OCCUPANCY 1 CO-19-2196 1 Printed 08/05/19 at 3:34 p.m. Page 1 of 3 J a i aMNay,LN1111 iC \�� `� y/�bUo j y/Ai \ v - / e s �s W: " AtlMgtlGIJ Nx W - \ 6O ry — � x`• "—'—'" 1s NItlWS ell 15 NItlW i �Ns Wq 111 N ST lit F7,70.1 a JNn 3 tW P s S m 13 3' ls'3NId y N I v ..�V /LLST p 41 rr °�3ntl3tel oN,y\\ /. /•n Y� ciwwz b4o�° 3~ wz'o �1 y, M 10\ wm J� m .JN v iLaW3 h i._—� y5 y I r rr e eS hPc>gw N'h�t9 S„y..� e M+4 aep s�yS' yei�r¢W m �o / CERTIFICATE OF OCCUPANCY WORKORDER PERMIT # 19 J.-,� ADDRESS OF INSPECTION: DATE OF INSPECTION: TIME OF INSPECTION: NAME OF BUSINESS: 22:� TYPE OF BUSINESS: USE OF BUILDING AND/OR PREMISES: REASON FOR APPLYING: �� CONTACT PERSON: c G TELEPHONE NUMBER: �2/4/-4/V COMMENTS/VIOLATIONS: 9--\ - 1q **TO BE FILLED OUT BY BUILDING OFFICIAL** ZONING DISTRICT OF INSPECTION LOCATION: H G TYPE OF BUILDING: V--o GROUP AND DIVISION: ZONING RESTRICTIONS: O.FOFA1£DSCOINFCRINTION R'ORFOFDFR I2]U OG Ru'1 F1.NO `�.. _•�.' �. .�/- ''�/. �1''� �'�__.��r--��'•- ��F_,__\sir✓ '+ZI'� w.�"__� f i N N N o o.T0 o `` � a� M C 0 N Q, N m c a) ' m Uaa O * Q C.N-� () X C)+� NJC N J 11J O N I/ rJ, , a�i 3 p " Lo �@w 0 c � a) } 1 c3Q T °{� UFX00 —ca y / Sk (6 J d N Z N (N M1 I — 0c 0 C O @ v V 2Qc a` OWW � a C) Z CAL o� �f1 Q U r J T m Ilk, U No> Q > O ° o a t0 x LL y Q- a C) c w O y J (� BOO U * ~ 0) ' If O O N.'-' F' W a)`o F _ U) NL C ' h i cQ o c c o O C.E y �O mQ E W c ma 0 L �C CU V k O o 0 3 u } CNN ,7 TC M C m U ) O J U S co N,C0 DUm m o m �— C n } OcmL U N 7 C H C a N 0_ N m 0 a ' V �fu U D C U Q c� m a .. 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