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Home My WebLink AboutPLBG2018-0813 ,V N Issue Date: T ' " s 5CITY OF GRAPEVINE ` 7 01 (CIRCLE O MECHANICAL - ELECTRICAL LUMBING IRRIGATION - FUEL GAS PERMIT A TION PLEASE PRINT LEGIBLY-COMPLETE ENTIRE FORM PERMIT# ' _O� ' BLDG.PERMIT# DATE: JOB ADDRESS: SUITE# . 4 G DESCRIPTION OF WORK: PROPER OW�N7ER: CON TR CTING COMPANY: / •� �G U ;•f• � Q/XU ic. L Zs+' c/e:C�( `/C/Lr'trf ADDRESS: ADDRESS:��v A, �� -✓ CITY/$TATEIZIP: CITY/STATEIZIP,: PHON UMBER _� PHONE NUMBER., TYPE OF OCCUPANCY BUILDING AREA PERMIT FEES / AMOUNT DUE SQ FT EACH TRADE I. R-3 1 - 749 $ 33.25 SINGLE FAMILY, DUPLEX 750- 1,199 $ 49.88 TOWNHOUSE, 1,200- 1,500 $ 63.18 NEW CONSTRUCTION& 1,501 - 1,750 $ 76.48 ADDITIONS (PER UNIT) 1,751 - 2,000 $ 83.13 2,001 - 2,250 $ 89.78 TOTAL SQ. FOOT UNDER 2,251 - 3,000 $ 96.43 ROOF 3,001 - 3,500 $ 103.08 3,501 - 4,000 $ 109.73 $ 4,001 + $ 120.37 EACH TRADE II. A, E, I, R-1 1 - 500 $ 37.00 HOTELS,APARTMENTS, 501 -100,000 $ 17.50+.035 PER DRINKING/DINING, 100,001 -500,000 $ 3,500.00+.03 SQUARE EDUCATIONAL,ASSEMBLY, 500,001 + $15,000.00+.02 FOOT $ INSTITUTIONAL EACH TRADE III. B, F, H, M, S, U OFFICE, RETAIL, WHOLESALE, 1 - 500 $ 37.00 GARAGES, FACTORIES, 501 - 50,000 $ 32.00+ .01 PER WORKSHOPS,SERVICE 50,001- 100,000 $ 182.00+ .007 SQUARE STATIONS, WAREHOUSE 100,001+ $ 582.00+ .003 1 FOOT $ CONTRACT EACH TRADE IV. ANY OCCUPANCY GROUP VALUATION OF WORK FINISH-OUTS, SHELL COMPLETIONS, 0- 500 $ 37.00 ALTERATIONS OR 501- 1,500 $ 45.00 STAND ALONE PERMITS 1,501- 3,000 $ 57.00 3,001- 5,000 $ 72.00 CONTRACT VALUATION OF WORK: 5,001- 50,000 $ 27.00+ .009 50,001-100,000 $ 127.00+ .007 P $ L.I✓ b� 100,001-500,000 $ 327.00+ .005 DOLLAER R 1 500,001+ $ 1,327.00+ .003 VALUATION V. MISCELLANEOUS EACH TRADE IRRIGATION SYSTEMS $ 37.001��,� MOBILE HOME SERVICE $ 37.00 TEMPORARY POLE SERVICE $ 37.00 SWIMMING POOLS $ 37.00 SIGN ELECTRIC $ 37.00 $ C:\FORMS\DS APPLICATIONS-FEMME APPLICATION 4-0i.d.c PLAN SUBMITTAL: WHEN PLANS ARE REQUIRED BY CODES, ORDINANCES, OR AS DETERMINED BY THE BUILDING OFFICIAL, THREE (3) SETS OF PLANS SHALL BE SUBMITTED IN HARD COPY FORMAT. ENGINEER SEALED PLANS AND CALCULATIONS SHALL BE SUBMITTED AS REQUIRED BY CODES, ORDINANCES OR WHERE OTHERWISE REQUIRED BY STATE LAW. OTHER INSPECTIONS AND FEES: • INSPECTIONS OUTSIDE NORMAL BUSINESS HOURS(2HR MINIMUM)...... ........................................$42.00/HOUW • REINSPECTION FEES.................................................................................................................. $42.00 • PERMITS FOR WHICH NO FEE IS SPECIFICALLY INDICATED........................................................... $37.00 • INSPECTIONS FOR WHICH NO FEE IS SPECIFICALLY INDICATED(1/2 HOUR MINIMUM)......................$42.00/HOUR • ADDITIONAL PLAN REVIEW REQUIRED BY CHANGES,ADDITIONS,OR REVISIONS TO APPROVEDPLANS.......................................................................................................................$42.00/HOUR BUILDING PERMIT FEES FOR THE GRAPEVINE-COLLEYVILLE INDEPENDENT SCHOOL DISTRICT SHALL BE 25%OF THE FEES ESTABLISHED IN THIS TABLE FOR USE OF OUTSIDE CONSULTANTS FOR PLAN CHECKING AND INSPECTIONS, OR BOTH.........ACTUAL COSTS" I 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 CODES 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. I FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH ANY FEDERAL, STATE, AND / OR LOCAL LAW REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS, AND THAT VERIFICATION OF ENERGY DE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST. !� SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT PRINTE NAME (OR HOMEOWNER FOR HOMEOWNERS PERMITS) PHONE#: 9�� '/ �S' !/ EMAIL: 'OR THE TOTAL HOURLY COST TO THE JURISDICTION WHICHEVER IS GREATER. —ACTUAL COSTS INCLUDE ADMINISTRATIVE AND OVERHEAD COSTS. Development Services Department,Building Inspections The City of Grapevine*P.O.Box 95104 *Grapevine,Texas 76099 *(817)410-3165 Fax(817)410-3012 *www.grapevinetexas.gov OAFORMS\DS APPLICATIONS-FEES\MEP APPLICATION 4-11.doc PLUMBING PERMIT {VALUE} Issue Date: February 27,2018 PROJECT DESCRIPTION: Replace Backflow Device for Coffee&Tea Machines"Original Pancake House" PROJECT# (817) 410-3010 www.mygov.us PLBG-18-0813 Inspections Permits City of Grapevine LOCATION TENANT LEGAL Grapevine,,T TX 76099 9 P.O.Box 1505 William D Tate Ave. Original Pancake House The Blk 1 Lot 5r X (817)410-3165 Voice Grapevine, TX 76051 Original Pancake House (817)410-3012 Fax CONTRACTOR INFORMATION Lawton Commercial Services[PLBG] County Tarrant State ID#41294 Square Footage 1444 N Central Expwy VALUATION 550 MCKINNEY,TX 75070 (972)424-2929 Phone Zoning CC- Community Commercial (469)742-2323 Fax FEES TOTAL=$45.00 (214)585-7041 Mobile Plumbing Permit Fee(VALUE) $45.00 OWNER PAYMENTS TOTAL=$45.00 Sb Hayward Llc Lawton Commercial Services[PLBG](David 433 N Camden Dr Ste 800 Everrett) Other on 0212712018 ($45.00) Beverly Hills, CA 90210 Note: CC5677 AVAILABLE INSPECTIONS NOTICES . Backflow Device Inspection(required) ALL work must be done in compliance with the 2006 INTERNATIONAL � TCEQ Backflow Certification Submit PLUMBING CODE. (required) � Plumbing Final(required) PLAN SUBMITTAL:WHEN PLANS ARE REQUIRED BY CODES, ORDINANCES, OR AS DETERMINED BY THE BUILDING OFFICIAL,THREE (3)SETS OF PLANS SHALL BE SUBMITTED IN HARD COPY FORMAT. ENGINEER SEALED PLANS AND CALCULATIONS SHALL BE SUBMITTED AS REQUIRED BY CODES, ORDINANCES OR WHERE OTHERWISE REQUIRED BY STATE LAW. READ AND SIGN I 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 CODES 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. I FURTHER CERTIFY THAT ALL WORK THAT IS REQUIRED TO COMPLY WITH ANY FEDERAL,STATE,AND/OR LOCAL LAW REGARDING ENERGY CONSERVATION WILL BE PERFORMED IN ACCORDANCE WITH THOSE LAWS,AND THAT VERIFICATION OF ENERGY CODE COMPLIANCE SHALL BE SUBMITTED TO THE CITY UPON REQUEST. Signature Date MAR 7 201E CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE ANNUAL TEST IRRIGATION PWS I.D.# 2200013 OTHERL7L7-,' Lz�Fr1 NAME OF BUSINESS WHERE DEVICE IS LOCATED: (21LILWIAZ Z�X/LX'/Cf 17O4z.Sr ADDRESS OF SITE SERVICED: yz PLUMBING PERMIT IF APPLICABLE: # 42Z dull - / 6 TESTER LICENSE NUMBER: (s `( ,3 1lI EXPIRES: DATE OF LAST TEST GAUGE CALIBRATION: 711111 7 THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TCEQ REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS. TYPE OF ASSEMBLY REDUCED PRESSURE PRINCIPLE _ PRESSURE VACUUM BREAKER DOUBLE CHECK —ATMOSPHERE VACUUM BREAKER MANUFACTURER: /,t)//'�.S SIZE: /L /z MODEL: / / 0/5 7 Ck i- SERIAL NUMBER: C'> 7,� 7Cl/ e3 PHYSICAL LOCATION OF METER: T/�f_f 51i7£- C�/ F2os2i ��121</sI� l_vi REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER DOUBLE CHECK VALVE AIR INLET CHECK VALVE ASSEMBLY / / 1ST CHECK 2"o CHECK RELIEF VALVE 3VII Open at psid psid DC-Closed Tight Loosed TiaW Initial _RP 2i psid 2 e � " Opened at Did not open Leaked Test D EL7 Leaked Leaked psid Er�S Repair Materials Used Test DC-Closed Tight Opened at Opened at After Closed Tight psid epa Rir _RP psid psid _psid The above is certified to be true. TESTERS FIRM NAME: �oi�rrr�Sf-c.!/dl- o2z��lF S ADDRESS: CITY/STATE/ZIP: DATE: ,3121/9� PHONE NUMBER: PRINT NAME: SIGNATURE: DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT(817) 410-3010 T,//S 0iFv/Cf �f;/�C//—f Y�; 11y/ vo7/,� 3Ui RoW,d 1,06, INRIGAIION INlUA6MKFl A1K'lLET REPORT doc Revised-1/O1,2/10 '