HomeMy WebLinkAboutDEMO2007-01496 110 DOMINIK DR DEMO PERMITS of Custody
pp,M-Bull€ ❑ Rush-1 day ♦�No ,=2 day # ❑ Extended PCM-Air: ❑ Rwh�ame day • ❑ 1-2 day
❑ ANALYZE ALL ;kPOSTTTVE STOP TEMBuWW[pe/Wa E) 24 hr 0 0 49 hr • ❑ 72 hr
**Pka:e can in advance for after -hour do weekend mesh analyeia" TEM-74o2JMomed:❑ 24 hr • ❑ 48 hr * ❑ 72 hr
Company Name and City: Austin Environmental, Inc.
Page of
Lab Job# _
Lab Job#
Lab Job#
Submitter's Name: Brent Plant amp a e. w — P.O. No:
Project No: f % �—
Project: ar•
Contact Informatlon: Name: Brent Plant
E-mail: (address):ren�i�t ahoo.com, pdehlingerQyahoo.com
Hard copy. (address): P.O. Box 3725, Bryan, Texas 77805
Invoice Address (if different):
-.--s_-__r-. j-&—...j6—urr.. eo l.i_ Unromfoked/L.omIrb oechwedarnrOusr exatsrlve rdwhrsrrtiW rf"cr&aroy incur addidpiulf6m ***
Phone #: 979.778.2699
Mobile #: 979.229A385
Fax * 979.778.2730
•' * Pkw wrier paP
Sample No.
(AA
jv+
0
14PA
Sample Description
Vol. f Area
Location ! dotes
4z -
C.� n .
, e, o,
r -J
�lr•0 1 ("Ac / ..J t
-
_f4a,
rya a rw�
'ct1'
r
Notes:
Steve Moody Micro Services. Inc. - 2051 Valley View LR - Farmers Branch, TX 75234 - (972) 241-8460 / FAX (972) 241-8461 NYLAP Lab #102056 TX DM IS License 9 30-0084 [COC 200 )
PLM REPORT
Steve Moody Micro Services, Inc. NVLAP Lab No. 102056
2051 Valley View Lane TDH License No. 30-0084
Farmers Branch, TX 75234 (972) 241-8460 PAT ID # 102577
Client : Austin Environmental, Inc. Lab Job No.: x713-04238
Project : Vacant Building, 110 Dominik Drive, College Station TX Report Date: 05/11/2007
Project # : AE07- Sample Date : 05/10/2007
Identification : Asbestos, Bulk Sample Analysis
Test Method : Polarized Light Microscopy / Dispersion Staining (PLM/DS)
EPA Method 600 / R-93 / 116 Page 1 of 2
On 05/11/2007, nine (9) bulk material samples were submitted by Brent Plant of Austin Environmental, Inc for asbestos analysis by PLM/DS
Copies of the lab data sheets are attached, additional information may be found therein. The results are summarized below
Sample Number
Client Sample Description / Location
Asbestos Content
OlA
Lay -In Ceiling Tile,
None Detected - Acoustic Tile
Dining Area, West Side at Dividing Wall
O113
Lay -In Ceiling Tile,
None Detected - Acoustic Tile
Counter, Middle at Grid (Upper)
01C
Lay -In Ceiling Tile,
None Detected - Acoustic Tile
Hallway, outside Restroom A
02A
Drywall Texture,
None Detected - Drywall Material
Dining Room, West Side, at Counter Dividing Wall
None Detected - Joint Compound
None Detected - Texture
02B
Drywall Texture,
None Detected - Drywall Material
Counter, at Wall under Window
None Detected - Joint Compound
None Detected - Texture
02C
Drywall Texture,
None Detected - Drywall Material
Wall, above Dry Food Storage Doorway
None Detected - Texture
03A
Drywall Texture Ceiling,
None Detected - Drywall Material
Dry Floor Storage, at Light above Electrical Panels
2% Chrysotile - Old Texture
None Detected - New Texture
03B
Drywall Texture Ceiling,
Not Analyzed - Positive Stop
Kitchen, Middle next to Light
03C
Drywall Texture Ceiling,
Not Analyzed - Positive Stop
Kitchen, next to Ceiling access Panel
PLM REPORT
Steve Moody Micro Services, Inc.
NVLAP Lab No. 102056
2051 Valley View Lane
TDH License No. 30-0084
Farmers Branch, TX 75234 (972) 241-8460
PAT ID # 102577
Client: Austin Environmental, Inc.
Lab Job No.: x713-04238
Project : Vacant Building, 110 Dominik Drive, College Station TX
Report Date: 05/11 /2007
Project # : AE07- Sample Date : 05/10/2007
Identification : Asbestos, Bulk Sample Analysis
Test Method : Polarized Light Microscopy / Dispersion Staining (PLM/DS)
EPA Method 600 / R-93 / 116
Page 2 of 2
On 05/ 11 /2007, nine (9) bulk material samples were submitted by Brent Plant of Austin Environmental, Inc. for asbestos analysis by
PLM/DS
Copies of the lab data sheets are attached-, additional information may be found therein The results are summarized below
Sample Number
Client Sample Description / Location
Asbestos Content
These samples were analyzed by layers Quantification, unless otherwise noted, is performed by calibrated visual estimate
Results may not be reproduced except in fill I This test report relates only to the samples tested.
These test results do not imply endorsement by NVLAP or any agency of the U.S Government
Accredited by the National Voluntary Laboratory Accreditation Program for Bulk Asbestos Fiber Analysis under Lab Code 102056
^ ^ W
AA
Analyst: Jessica Scott
Lab Director: Steve Moody
Approved Signatory :
Thank you for choosing Steve Moody Micro Services ---- ------------------------ ----------------------------------- ------" ----------
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No 30-0084 EPA Method 600 / R-93 / 116 NVLAP Lab No 102056
Client : Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 01A
Client Sample Description: Lay -In Ceiling Tile, Page 1 of 1
Dining Area, West Side at Dividing Wall
Layer 1 Acoustic Tile Stereoscopic Exam
Color Texture Homogeneous' %Fibrous % Asbestos % of Sar
Light Grey I Fibrous YES 80 I D 100
PL i nxammauon
Corn nents
%
+/-
Morphology
Color
/ Pleochrorsm
Parallel
Ref Index
Perpendicular
Ref Index
Brref
Extmctron
An le
Srgn of
Elon atron
ellulose Fibers
50
ribbons
high
ineral Wool Fibers
30
Rods
0
Perlite
20
lass Foam
0
Prep/treatment mechanical Is
I Comments:
Asbestos Content. None Detected
Analyst: Jessica Scott
Date Analyzed: 05/11 /2007
Lab Job# : x7B-04238 Sample # :01A
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No 30-0084 EPA Method 600 / R-93 / 116 NVLAP Lab No 102056
Client : Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 01 B
Client Sample Description: Lay -In Ceiling Tile, Page 1 of 1
Counter, Middle at Grid (Upper)
Layer 1 Acoustic Tile Stereoscopic Exam
Color Texture Homogeneous' %Fibrous %Asbestos %ofSaniple
Light Grey Fibrous YES 1 80 1 ND I 100
PLM Examination
Color
Parallel
Perpendicular
Extinction
Sign of
Components
%
+/-
/ Pleochroism
Ref. Index
Ref. Index
Biref
Angle
Elongation
Cellulose Fibers
5C
-Morphology
ribbons
high
Mineral Wool Fibers
3
Rods
0
erlite
2C
Glass Foam
0
Prep/treatment mechanical separation
I Comments :
Asbestos Content None Detected
Analyst: Jessica Scott
Date Analyzed: 05/11/2007
Lab Job# : x7B-04238 Sample # :01 B
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No 30-0084 EPA Method 600 / R-93 / 116 NVLAP Lab No 102056
Client : Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 01C
Client Sample Description: Lay -In Ceiling Tile, Page 1 of 1
Hallway, outside Restroom A
Layer 1 Acoustic Tile Stereoscopic Exam.
Color Texture Homogeneous9 % Fibrous % Asbestos % of Sar
Light Grey Fibrous YES 80 1 ND 100
PLM Examination
Color
Parallel
Perpendicular
Extinction
Sign of
Components
%
+/-
Morphology
/ Pleochroism
Ref Index
Ref Index
Biref
An le
Elongation
Cellulose Fibers
5C
ribbons
high
Mineral Wool Fibers
3
Rods
0
Perlite
2C
Glass Foam
0
Prep/treatment mechanical separation
Comments :
Asbestos Content: None Detected
Analyst: Jessica Scott
Date Analyzed: 05/11/2007
Lab Job# : x7B-04238 Sample # :01 C
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No. 30-0084 EPA Method 600 / R-93 / 116 NVLAP Lab No 102056
Client: Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 02A
Client Sample Description: Drywall Texture, Page 1 of 1
Dining Room, West Side, at Counter Dividing Wall
Layer 1 Drywall Material Stereoscopic Exam
Color Texture Homogeneous % Fibrous I % Asbestos % of Sample
White Blocky YES 3 ND 5
PT M Fvain —f—n
Components
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
Cellulose Fibers
ribbons
high
Gypsum / Binders
9
Non -fibrous
Prep/treatment mechanical separation
Layer 2 DW Paper / Tape Stereoscopic Exam
Color
Tan / White
PT.M Fxaminatinn
Asbestos Content None Detected
Texture Homogeneous % Fibrous % Asbestos % of Sa
Fibrous YES 1 100 ND 1 25
Components
�ellulose
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref. Index
Biref
Extinction
Angle
Sign of
Elongation
Fibers
1 100
1 ribbons
I
I
high
Prep/treatment : mechanical separation
Layer 3 Joint Compound
PI .M F.xa m matinn
Asbestos Content. None Detected
Stereoscopic Exam .
Color Texture Homogeneous % Fibrous % Asbestos % of Sample
White Blocky YES I ND I ND 1 5
Components
�alclte
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
I Talc I Binders
1 100
1 Non -Fibrous
Prep/treatment . mechanical separation
Layer 4 Texture
PI .M F.xaminatinn
Asbestos Content None Detected
Stereoscopic Exam :
Color Texture I Homogeneous % Fibrous % Asbestos % of Sample
White Blocky I YES I ND I ND 1 65
Components
�alclte
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Beef
Extinction
Angle
Sign of
Elongation
I Talc / Binders
1 100
1 Non -Fibrous
Prep/treatment mechanical separation
Comments :
Asbestos Content None Detected
Analyst: Jessica Scott
Date Analyzed: 05/11 /2007
Lab Job# : x7B-04238 Sample # :02A
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No 30-0084 EPA Method 600 / R-93 / 116 NVLAP Lab No 102056
Client : Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 02B
Client Sample Description: Drywall Texture, Page 1 of 1
Counter, at Wall under Window
Layer I Drywall Material Stereoscopic Exam:
Color Texture Homogeneous % Fibrous % Asbestos % of Sample
White Blocky YES 3 ND 1
PT M Fxam inatinn
Components
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
Cellulose Fibers
ribbons
high
Gypsum / Binders
90
Non -fibrous
Prep/treatment : mechanical separation
Layer 2 DW Paper Facing Stereoscopic Exam .
Color
Tan
PLM Examination
Asbestos Content - None Detected
Texture Homogeneous % Fibrous % Asbestos % of S,
Fibrous YES 1 100 1 ND 1 3
Components
�ellulose
%
+/-
Mo holo
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
Fibers 1100
1ribbons
I
I
high
Prep/treatment mechanical separation
Layer 3 Joint Compound
PLM Examination
Asbestos Content None Detected
Stereoscopic Exam .
Color Texture Homogeneous %Fibrous I %Asbestos %of Sample
White Blocky YES I ND ND 10
Components
�alcite
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
/ Talc / Binders
1 100
1 Non -Fibrous
Prep/treatment mechanical separation Asbestos Content. None Detected
Layer 4 Texture Stereoscopic Exam
Color Texture Homogeneous' % Fibrous I % Asbestos % of Sample
White Blocky YES ND I ND 86
PLM Examination
Components
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
alcite / Talc / Binders
1 100
1 Non -Fibrous
Prep/treatment mechanical separation
Comments :
Asbestos Content None Detected
Analyst: Jessica Scott
Date Analyzed: 05/11 /2007
Lab Job# : x7B-04238 Sample # :02B
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No 30-0084 EPA Method 600 / R-93 / 116
Client : Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 02C
Client Sample Description : Drywall Texture,
Wall, above Dry Food Storage Doorway
Layer 1 Drywall Material Stereoscopic Exam.
Color Texture
White Blocky
PLM Fxaminahnn
NVLAP Lab No 102056
Page 1 of 1
ogeneous9 l % Fibrous 1 % Asbestos I% of Sa
YES 1 3 1 ND 1 75
Components
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
Cellulose Fibers
ribbons
high
Gypsum / Binders
4-1
Non -fibrous
Prep/treatment. mechanical separation
Layer 2 DW Paper Facing
PLM Fxnmimtinn
Asbestos Content: None Detected
Stereoscopic Exam
Color Texture I Homogeneous % Fibrous I% Asbestos % of Sample
Tan Fibrous I YES 1 100 1 ND 1 20
Components
%
+/-
Morphology
o holo
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref. Index
Biref
Extinction
Angle
Sign of
Elon ation
ellulose Fibers
111011
1ribbons
I
I
Ihigh
Prep/treatment mechanical separation
Layer 3 Texture
PLM Fxammatinn
Asbestos Content: None Detected
Stereoscopic Exam .
Color I Texture Homogeneous % Fibrous % Asbestos % of Sample
White I Blocky YES I ND I ND I5
Components
�alclte
%
+/-
Mo holo
Color
/ Pleochroism
Parallel
Ref. Index
Perpendicular
Ref Index
Biref
Extinction
Angle
Sign of
Elongation
/ Talc / Binders
I 10q
I Non -Fibrous
Prep/treatment mechanical separation
Comments:
Asbestos Content None Detected
Analyst: Jessica Scott
Date Analyzed: 05/11/2007
Lab Job# : x70-W38 Sample # :02C
Steve Moody Micro Services, Inc. Bulk Asbestos Analysis Sheet
TDH License No 30-0084 EPA Method 600 / R-93 / 116 NVLAP Lab No 102056
Client : Austin Environmental, Inc.
Project : Vacant Building, 110 Dominik Drive, College Station TX
Project # : AE07- Lab Job# : x7B-04238 Sample # : 03A
Client Sample Description: Drywall Texture Ceiling, Page 1 of 1
Dry Floor Storage, at Light above Electrical Panels
Layer 1 Drywall Material Stereoscopic Exam
Color Texture Homogeneous' % Fibrous I % Asbestos % of Sample
Pink Blocky YES 2 NO 63
Pf M Fvami—f—
Components
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Buef
Extinction
An le
Sign of
Elongation
Glass Wool Fibers
2
Rods
0
Cellulose Fibers
1
ribbons
high
Gypsum / Binders
97
Non -fibrous
Prep/treatment mechanical separation
Layer 2 DW Paper Facing
PT M Fr —t—n
Asbestos Content None Detected
Stereoscopic Exam
Color Texture Homogeneous' % Fibrous % Asbestos % of Sample
Tan Fibrous YES 1 100 1 NO 1 30
Components
�ellulose
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Buef
Extinction
Angle
Sign of
Elongation
Fibers
I 10q
I ribbons
I high
11
Prep/treatment mechanical separation
Layer 3 Old Texture Stereoscopic Exam
Color
Off -White
PT M Pv t
Asbestos Content. None Detected
Texture I Homogeneous' l % Fibrous I % Asbestos 1% of Si
Blockv I YES I NO I NO 1 2
Components
%
+/-
Morphology
Color
/ Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
Buef
Extinction
Angle
Sign of
Elongation
hrysotile
1
silky / wavy
None
1.556
1.548
low
0
+
Calcite / Talc I Binders
9
Non -Fibrous
Prep/treatment mechanical separation
Layer 4 New Texture Stereoscopic Exam
Color
White
PLM F.xam matinn
Asbestos Content 2% Chrysotile
Texture I Homogeneous % Fibrous % Asbestos % of S-'
Blockv I YES I NO NO 5
Components
%
+/-
Morphology
Color
/Pleochroism
Parallel
Ref Index
Perpendicular
Ref Index
I
Biref
Extinction
Angle
Sign of
Elongation
alcite / Talc / Binders
100
1 Non -Fibrous
Prep/treatment mechanical separation
Comments :
Asbestos Content None Detected
Analyst: Jessica Scott
Date Analyzed: 05111 /2007
Lab Job# : x7B-04238 Sample # :03A
CITY OF COLLEGE STATION
BUILDING INSPECTION DEPARTMENT
REVIEWED FOR COMPLIANCE
PER NOTES ON PERMIT
NO COMMENTS
Y RFR NOTES HIV PLANS/SH 65
VI 1 Y %Jr .r ■ ff, V .-.
Building Inspection Department
Received
Reviewed
ts &N. sQf
�l�
DEMOLITION PERMIT
CITY OF COLLEGE STATION
1101 'TEXAS IAVE
COLLEGE STATION, TX 77840
PHONE: (979)764-3570 FAX: (979)764-3496
----------------------------------------------------------------------------
Application Number . . . . .
Application pin number . . .
Property Address . . . . . .
Property ID:
R #:
Tenant nbr, name . . . . . .
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Property Zoning . . . . . . .
Application valuation . . . .
07-00001496
118480
110 DOMINIK DR
213500-0002-0070
R25423
Date 5/25/07
REMOVE INTERIOR WALL
DEMOLITION, COMMERCIAL
CULPEPPER PLAZA
GENERAL COMMERCIAL
500
Owner Contractor
------------------------ ------------------------
FAI ZULLAH , GULAMAL I S & OWNER `Th�J
e_ f
HABIBAH
3219 CATERINA LN
COLLEGE STATION TX 778456308
--- Structure Information 000 000 DEMO PERMIT
Construction Type . . . . . COMBUSTIBLE (UNPROTECTED)
Occupancy Type . . . . . . ASSEMBLY (IBC)
Other struct info . . . . . IMPACT/PRORATA FEES PAID NA
HEATED AREA 1.00
INTERIOR WALL TYPE NA
TAZ 279.00
----------------------------------------------------------------------------
Permit . . . . . . DEMOLITION PERMIT
Additional desc . . KW
Permit pin number . 504902
Permit Fee . . . . 25.00 Plan Check Fee .00
Issue Date . . . . 5/25/07 Valuation . . . . 500
Expiration Date . . 11/21/07
Qty Unit Charge Per Extension
BASE FEE 25.00
----------------------------------------------------------------------------
Special Notes and Comments
ELECTRICAL SHALL BE INSTALLED PER 2005 National Electrical
Code & LOCAL AMENDMENTS
CONSTRUCTION ACTIVITY BETWEEN THE HOURS OF 10:00 PM AND
7:00 AM MUST COMPLY WITH THE NOISE ORDINANCE (MAX. 55 DBA)
ANY CHANGES OR ALTERATIONS TO SUBMITTED PLANS MUST BE
RESUBMITTED AND APPROVED BEFORE WORK IS DONE IN ORDER TO
ASSURE CODE COMPLIANCE
POST PERMIT CARD ON JOB SITE
------------------------------ --------- - - ------------
BUILDING DEPT REPRESENTATIVE:
APPLICANT: //'�w
DEMOLITION PERMIT
CITY OF COLLEGE STATION
1101 TEXAS'AVE
COLLEGE STATION, TX 77840
PHONE: (979)764-3570 FAX: (979)764-3496
----------------------------------------------------------------------------
Page
2
Application Number . . . . .
07-00001496
Date
5/25/07
Application pin number . . .
118480
----------------------------------------------------------------------------
Special Notes and Comments
ALL PLUMBING, ELECTRICAL, AND
HVAC (mechanical)
WORK MUST
BE PERFORMED BY LICENSED CONTRACTORS. CONTACT BUILDING
DEPARTMENT FOR INSPECTIONS
PRIOR TO COVERING
ANY WORK
----------------------------------------------------------------------------
Fee summary Charged
----------
Paid Credited Due
------------------------------
-----------------
Permit Fee Total 25.00
25.00
.00
.00
Plan Check Total .00
.00
.00
.00
Grand Total 25.00
25.00
.00
.00
a
---------------------------------------------- ------
BUILDING DEPT REPRESENTATIVE:
'/l. , -/1
APPLICANT:
APPLICATION FOR BUILDING PERMIT
1101 TEXAS AVENUE
COLLEGE STATION, TX 77840
(979) 764-3570 (979) 764-3496 FAX
CITY OF COLLEGE STATION WWW.CSTX.GOV
Plan_' d Deo bhment Seevirrs
ADDRESS/LOCATION: �)I rD
LOT �_ BLOCK SUBDIVISION
(ma , ( For Office Use Only
DATE: `'y Iiq vITRCC REG
APPLICATION #
TEMP POLE #
SEC/PH
BUSINESS/OWNER NAME: JVlic_oN 1-LL PHONE:
CONTRACTOR/HOMEOWNER:
CONTRACTOR ADDRESS:
ELECTRICIAN:
HVAC:
PHONE:
PLUMBER:
_ GOOD CENTS (Residential only):
CLASS OF WORK
ACCESSORY/STORAGE LOCATION RE -ROOF
,ADDITION MOVING SHELL ONLY
DEMOLITION (Asbestos Survey) NFW CONSTRUCTION ` SLAB ONLY
DUPLEX (Landscape Plans) FMODEL/RENOVATION' SWIMMING POOL
TENT/CANOPY
DESCRIPTION OF WORK: kysy;'�Mc_ A t5zCQ,.
PROPOSED USE: �w►o o v► f� rr�%� ONfy 7?e /d�•^fo
HOMEOWNER ASSOCIATION/ARCHITECTUAL OR DESIGN REVIEW COMMITTEE APPROVAL:
TEXAS ACCESSIBILITY STANDARD (TAS) PROJECT REGISTRATION# EABPRJ
VALUATION: $ S ")a 03 TOTAL AREA: HEATED AREA: aLA, s� FI-
(Cost of Labor and Materials)
PUBLIC SEWER
SEPTIC/TREATMENT SYSTEM
SEWER TAP:
WATER TAP:
OTHER TAP:
TEMP POLE
GARAGE TYPE:
JIZE
SIZE
SIZE
SINGLE
EJ
ATTACHED
NUMBER OF BEDROOMS:
NUMBER OF BATHROOMS:
INTERIOR WALL TYPE: L-\j-
EXTERIOR WALL TYPE:
Avt� - 4%
FOUNDATION TYPE:
ROOF TYPE:
DOUBLE 0 TRIPLE 3*
DETACHED = CARPORT
SIGNATURE OF APPLICANT:
*If proposed work involves new co ercial construction or facade improvements/renovations to an existing
commercial property, building elevations are required.
♦����p�����������������������������������������++++��������♦
Official Use Only
Plans Examiner Zoning Official Fire Marshall
C ts:
ESN
Vt.-)
Energy Code Compliance Information
% Glazing of exterior walls
Insulation R value of exterior walls
Insulation R value of ceiling 1 (flat areas)
Insulation R value of ceiling 2 (vaulted areas/no attic)
Glazing SHGC
Glazing U-Factor
R value of ductwork
A/C SEER Rating
C
4
fi� ♦ �e � y^. ; .�it• ,,, tarry^� � ` t� S Ca 1 ti •�� c� Sic: ; � 't