HomeMy WebLinkAboutCO2019-4721 UNDER CONSTRUCTION _
CORRECTION LETTER_
PW OR LID NEEDED _
TD NO LETTER_
WAITING FIRE_
HOLD
CODE
C/O CHECK LIST
C/O PERMIT # P19 - L- 'j_3_�j
ADDRESS: I(9DU
BUSINESS NAME: u-C
BUSINESS I PROPERTY
CHANGE NAME / OWNER _ NEW CONST/ADDITION PERMIT#
NEW TENANT/ OCCUPANT - REMODEL/ALTERATION PERMIT#
ISSUE DATE FINAL DATE
__v 1. APPLICATION FORM COMPLETED
t,�eI2. 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)
FIRE DEPARTMENT APPROVAL OF HAZARDOUS MATERIAL DATE
✓ 5. ZONING CHECKED & COMPLETED ON APPLICATION nn
V/ 6. BUILDING INSPECTION SCHEDULED DATE 1 TIME
'✓ 7. FIRE DEPT. INSPECTION SCHEDULED DATE 1 ME �M
FIRE INSPECTOR:
'-1 8. CITY SECRETARY(ALCOHOL) NOTIFICATION DATE:
HEALTH INSPECTION NOTIFICATION DATE:
�0. PUBLIC WORKS INSPECTION E-MAIL DATE
, "'l1. LOT DRAINAGE INSPECTION E-MAIL DATE
� 12. CORRECTION LETTER SENT DATE
V 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
_je�1'9. LANDSCAPING SIGN OFF
20. BUILDING OFFICIALS SIGNATURE f
✓21. C/O CERTIFICATE ISSUED ELECTRIC RELEASED: I f I✓
SCAN CERTIFICATE TO MYGOV:
* CONDITIONS TO BE TYPED ON C/O? YES / NO MAILED:
OAFORMS\OSCOINFORMATIONIGK IST
1213W 1 Rev.11111,11115.5118
DATE OF ISSUANCE: 100 51 `
VINE ^�
2019 T g x A s PERMIT#: O '
CERTIFICATE OF OCCUPANCY REQUEST
FEE: $50.00
NO FEE REQUIRED IF CERTIFICATE OF OCCUPANCY IS ASSOCIATED W`ITHANACTIVE CURRENT BUILDING PERMIT
ADDRESS OF OCCUPANCY: 16jo W eoilefP JT ,-SUITE
,#1 310
LOT: / BLOCK: t}-
****CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED WI1rHOUT LEGAL DESCRIPTION****
NAME OF BUSINESS: 93 R��er�e ��(�l 11Q Ota"ji cme fu t
NEW OCCUPANT: YES ( NO NEW BUILDING/PROPERTY OWNER: YES NO
NEW BUILDING: YES NOT NEW BUSINESS NAME CHANGE: YES NO�( _
NUMBER OF EMPLOYEES: i FREIGHT FORWARDING: YES
filNO _
I /' NEW BUSINESS OWNER: YES NO
)C _
TYPE OF BUSINESS: t'(A 1 Lh 0 till SQUARE FOOTAGE:
(Example:Retail Clothing/Attorney's Office./Office-Warehouse/Restaurant) /'
NAME OF TENANT IPERSON'SNAME]: (� n(�fP�or� � �vl���✓+�.1,
CURRENT MAILING ADDRESS: PO o)C /"I L 2q� l
CITY/STATE/ZIP: SOl/ Ie//s � �1� / 6 001 Z PHONE NUMBER: 2 i4i
PROPERTY OWNER: !�E'�a/ l�/c�?�e fey N l�k'Usf
MAILINGADDRESS:,_I-33 t o oje5t- 1C/IC1 Ale, 7y17e -760 �l /�
CITY/STATE/ZIP: /J1t 5 h y it l e, �N .3 7 2 0 j PHONE NUMBER: 2 1 / ' �I o3 ' -iD'Z_
♦ IS YOUR BUSINESS SUBJECT TO SALES TAX LAW? (if yes,provide copy of Sales Tax Certificate)---- YES_NO
♦ WILL THERE BE ALCOHOLIC BEVERAGE SALES? (if yes,provide copy of Alcoholic Beverage Permit)-YES_NO
♦ PERMITS ARE REQUIRED FOR SIGNS. WILL ANY SIGNS BE INSTALLED?------------------- YES_NO�C
♦ 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 X
♦ WILL THERE BE ANY OUTSIDE STORAGE(including storage of company/fleet vehicles),DISPLAY,
USEOR DINING?------------------------------------------------------------------ YES NO
♦ WILL ANY ALTERATIONS BE MADE TO THE SITE OR BUILDING?------------------------- YES NO )C
♦ IS BUILDING SPRINKLERED?------------------------------------------------------- YES X 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 PLEAS LL 1' 4 6 65.
SIGNATURE: PRINT NAM
EIE
PHONE#: 3 L S EMAIL: (/
(OVER)
Development Services Department
The City of Grapevine *P.O.Box 95104* Grapevine,Texas 76099 (817)410-3165
Fax(817)410-3012* www.erapevinetexas eov
O:FORMSIOSAPPLICATIONSIC/
3/22 2001/Rev:5/06,2/07,4/09,2113,11115,10/18,8/18
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 malting 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: A //4
Signature:
WHERE DO YOU WANT YOUR COMPLETED CERTIFICATE OF OCCUPANCY MAILED?
(�
ADDRESS: / (Q /3ox "I Z Zz�g
CITY,STATE, ZIP: J 4 u-i-A j--t ke, -rK -160q 2-
*** ************** *****x****FOR OFFICE USE
TYPE OF CONSTRUCTION: LA 5re- OCCUPANCY: DIVISION:
ZONING DISTRICT: 4RG I� CONDITIONAL USE: 4"
PERMITTED USE: Y-i,;; 5 )
BUILDING DEPARTMENT: - DATE: /2- Z
BUILDING INSPECTO . DATE:
ZONING APPROVAL: DATE: ] /
FIRE DEPARTMENT: mm DATE: C ` -r
LOT DRAINAGE INSPECTION: DATE:
PUBLIC WORKS DEPARTMENT: DATE:
HEALTH DEPARTMENT: DATE:
CITY SECRETARY: DATE:
LANDSCAPING APPROVAL: DATE: t Z,- t qtP
APPROVAL FOR ISSUANCE: DATE:
0:FORMS108APPLICATIONSIC/
322/2001/Rev:5/06,2/07,4/09,2/13,11/15,10/16,8/18
CERTIFICATE OF OCCUPANCY
' ) ' Issue Date: December 13,2019
PROJECT DESCRIPTION:C/O(Medical Office)"X3 Regenerative Medicine,PLLC"
r
# PROJECT# (817) 410-3010 www.mygov.us
CO-19-4721 Inspections Permits
City of Grapevine ----
LOCATION TENANT LEGAL
Grapevine,,T TX 76099 Y
P.O. Box 1600 W College St. X3 Regenerative Medicine, Baylor Med Ctr Condo
X
Suite#320 PLLC Baylor Med Ctr Condo Units
(817)410-3165 Voice Grapevine,TX 76051 7 Thru 14 Im Onl Medical
(817)410-3012 Fax p y
Off Bldg& Family Cln
CONTRACTOR INFORMATION
Gregory Davidovich * CONSTRUCTION TYPE IA-Sprinklered
P.O. Box 92248 *OCCUPANCY GROUP B
Southlake, TX 76092 *ZONING DISTRICT PCD
(214)232-3745 Phone
NAME OF BUSINESS X3 Regenerative Medicine PLLC
TYPE OF BUSINESS Office
OWNER **APPLICANT NAME Gregory Davidovich
Hrt Properties Of Texas Ltd **APPLICANT PHONE NUMBER 214-232-3745
3310 W End Ave Ste 700 **TENANT NAME Gregory Davidovich
Nashville, TN 37203-1097 **TENANT PHONE NUMBER 214-232-3745
AVAILABLE INSPECTIONS *Sales Tax YES
Final Building C/O Inspection (required) *Sales Tax Number
Final Fire Dept Inspection (required)
. Landscaping (required) Alcoholic Beverage Sales NO
C/O APPROVED FOR ISSUANCE Alterations NO
(required) 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 1
Outside Refuse/Recycling NO
Outside Storage NO
Signs NO
Square Footage 1931
Zoning PCD-Planned Commerce
Development
FEES TOTAL=$50.00
Certificate of Occupancy $ 50.00
PAYMENTS TOTAL=$50.00
D�. 1z G cR o15
<n a
CC Ej ' jf T
PODM PpO;
a ONS\O Y, ,n Fp aam M� n HU085 1 paPP6�P0.K , i Q�P'U` DOVE t =B 1 400N FO N n
6a'O.Ig55 an3 C ° ° OnCO C� f �0't5 iaea� oF4�6oF1M zo.m+® 0,,O,oa�551 10v3) .� 0.s6q�1 Pp6p'I
PO g R-7.5
WINORTHW ES9HWd' HC
PO Sj °t°,HE peat. Sp,ODN R�38Ep ta4 a�o
�au� CF`U T3 ppy'ISH. tHWE �1 sari ,R,n 4Q45 4 R '2m
2a° Ev\ NOR pyP t ,® 41 ®,
PO A A
1 23355
SP G
PF•P'NRO 80325 ,R 3125,
W6g5H rc: e�PODN _ i I
C 1604 PO
95' �f At,ib i yew® P�
H14
s°�40 P55EG5p
o
zoo® R-7.5 O 50 r A o=C+R
o
=®,
cc a
r
,R-12.5
SWB.to j ° v
ry24
p�,ST EB' Rz HEAfHE
IR
OSIER WIWALM1p' z° G .RES.� = RI
H 3 PF 4555 _ I rc
C
oR laa, e R : pI 10 a5°,°
p
pE4`40.E5
MEo\C'PV aaEVEVERGREEN i8 'I tB t + CHELSEA
SVRG ER 's 5 CT CT z , II ,e ° ST
,° f R-$a5 i` 8 s ,
�ylr� nP� E /,R FERN r< ,.14
a° c BR POT m =oR ,a ii 3 ° ru a fa on rp ° GU
F P
c v w ra Z v
W W r= B i3
k oe O
ie \ z.zom'nc 0. ne 1B f° n
PO =+ 9 10 I m W GOLEEGEfST
PN 0,
a R —
s R 7.5
VE EP I,a
0107 r'ry R =rxx �� P1'A6 I to E.GE B
='.z® xt„a ,isR= e�� I ,f G EB�
s NCEHt Ev\NE PCD I a
LI E5 =a , :=f ,° ,°
16
�® pF � y p \UM5 tr. PRN5K II '+
OXEORD-LN
O N Q P
\L&PRO ,s"50 CIEo O F P f z °
°
Si
tNO PO j4
406 v=n� L O
A 2f C`�`�9� + 7 n zz 22 zt; mD is
18
Je mreuu!l�G6 =s..es® - I a EATON�LN
os:a, F I o
9
D 17,
sD
^ •? 6'H
Cli fy 9pPpi I W zi
q�< ,. I m z=
z =o
W HUDGMS 5T
/y EpNCASTEa• i C\-EP K - ;, ,° s
C\-EPPµKW '2' p PT 5F 2 �--
y 1450
S %%A-E WOOD5-AVE
Stke
H
�f 2 �e n30�EB� GE S R 2 s
O F IRA E.V�OODs. °c:�i.0 p'rr y�i.Sy? £+1{> =.=f<® p2 q
O c"y� EXD SH SFi�IRASE�.E.WO m'=m'/3 r �• O sF _INI f°� 7
F9Zi\ypSn.eFilAWa DS WB�p.rn�c4.1-14)O�f�iW 9 R,'�'Y�+'y _ S'L e,1��Om
000 SH WOO FOODS AVcy,#Q�
1 inch = 400 feet Grid Page:
CERTIFICATE OF OCCUPANCY
WORKORDER
1 PERMIT # 19 - L�--j c)--1
ADDRESS OF INSPECTION: i,Z1. Go 1 l L c 3 ��
DATE OF INSPECTION: 1 �-J TIME OF INSPECTION: P
NAME OF BUSINESS: V �Er1��Ccc lGt"l O'L�L( ne LUC
TYPE OF BUSINESS: Cx
USE OF BUILDING AND/OR PREMISES: C
REASON FOR APPLYING: ��� ✓��y�CC11�
CONTACT PERSON: LC CA azy"CLo y� c-L
TELEPHONE NUMBER:
COMME SNIOLATIONS:
r
**TO BE FILLED OUT BY BUILDING OFFICIAL**
ZONING DISTRICT OF INSPECTION LOCATION:
TYPE OF BUILDING: / -A GROUP AND DIVISION:
ZONING RESTRICTIONS:
O.FORNI5 OSCOINFORMATION\ORROROFR
1210 04 Ru'_1 17 2006
4�
r U L
o
w
° M
E A,` T
U cco-
3
U N
9 O W
SoN
Q� _F CO O
o O 6 t
ca�c 3 S? a Z
T C
3N � 0) 2 > r,
p0m C. 2 M Z - W
v
ca U
a N¢ . .
co:'
N
N o> N 4
O „ ) N o °' x
CL R w o ° '� o
° U * N m
(7 O o o d:�' J= F
° 0 U
2�
; . UQ CQ ° U W f
V NU °o a °
V. NNN oCL
L �,
:. . ��� 0 E
a/ =OOE E
.c
N NN c J _ _
-= j-p m d Y C
N .L d C yXu1y'`w.
1 U � �� a ' °
t U EOm � N � � Lo
co
r'
w om m m
0> L) ° d o CD o a
m
w Coo o_ ,,; NUM > •N ° U
U0
H m co U m t
HU3.o d _-
O U N '
lig OVA .'