FEMA-EC980323�0
BUILDING PERMIT APPLICATION
1444 , 6 Print or Type in a Clear, Legible Manner
Job Address: � j � �i� � � `T � j
Date:
Lot: Block: Subdivision:�p
Phase or Section Number:
1
Owner Address:
Phone #:
Contractor: PF-- P -)Q- Address:77C, , f 1
Phone #: 7 oq) � % f _ c
I `❑
Description of Work to be Done Class of Work: New El Addition
El Alteration El/Repair Demolition
N &-W :s Q(E) -F' M I LY
71� 3,56 1
Area of Building in Square Feet
� G (0 n
First Floor Garage
Value Work
Second Floor Other
of
to be Performed I vo
2-2-1 GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee: '
Receipt Number: '
This permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended or abandoned for a period of 180 days
�
Zoning DistT'ta:
Occupancy Classification:
at any time after work is commenced.
I hereby certify that I have read and examined this application and know the same to be true
Approved By: A"
Date:
I X
and correct. All provisions of laws and ordinances governing this type of work will be
Comments:
409
complied with whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other federal, state or local law
regulati g construction of he performance of construction.
Signature of Contra for or Authorized Agent Print Name D
July .21
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
Zyf~,
I�
4' CONC. WALK
P/D/S 950 S.F.
w
MINIMUM f f. �}$ 2_'
REVIEWED
;v I
DATE _ __ _ :o
Pr®val of the pla and specifications shall w
r,ClnStr c01 t0 s'nean c
the City of Coein direct cont",,
ll B
g codes and Zoma
PATIO �•l
•
W
54'-11.0000" Pao
i
W
O
0 3561—E3
TWO—STORY
FLOOD PLAIN LINE
20' BUILDING LINE
Mar €--�
7.5' UTILITY ESMT.
BENT TREE COURT
PER_�').Y HOMES DESIGN
• - 1987 - PERRY HOMES- .
ARCHITECTURE & INTERIORS
P.O. BOX 34306 HOUSTON, TEXAS
El
L
S
C
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D
711 DCAIT T017C
> : 26
Block:
B
ec Ion: 01
jbdiV
OMNSULAS OF COPPELL
No
on0703 6
ty. COPPELL , TEXAS
p�pr�OVe x
;Ole:l, = 20'-0"
DrowLAS
ate: 0% /(T9 /` p, RF\/ n,) /11 /QR
ure n ---
FORM SURVIY
SUBDIVISION: 4mouyIA)6 PZi07 DF %NGt RA)l ? is OF al,45'CL
BLOCK: 9 LOT: 2�
STREET ADDRESS: / Eit�1 �E'E
CITY: '�iq S
aF
�,-
5�� 23 °
T h'ACT 3
C,E
CARE6. p� EST
4� ,S l010 N
I hereby certify that the furan are in place
upon this lot according to the distances to
property lines shown, std were determined
from a survey made on the ground.
DATE:
0...............................IRON ROO
—X—X—. . ................... FENCE LINE
—T--E—. ...... ... ......UTILITY LINE
N �
T.W. BARROW
REGISTERED PROFESSIONAL
LAND SURVEYOR
7104 GRAPEVINE HIGHWAY
FORT NORTH, TEXAS 76118
(817) 268-0200
SCALE: 1"=20'
- ELEVATION CERTIFICATE O.M.B. No. 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31,1999
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro-
vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine
the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not
required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form.
Instructions for completing this form can be found on the following pages.
BUILDING OWNER'S NAME
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I
POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER CO PANY NAIC NUMBER
711 Bent Tree Court
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lot 26, Block B Amending Plat of The Peninsulas of Coppell
CITY STATE ZIP CODE
Coppell Texas
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
S. FIRM ZONE
6. BASE FLOOD ELEVATION
(in AO Zones, use depth)
480170
0010
E
4-15-94
X
453.0
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ® NGVD '29 ❑ Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: I I ! .IJ feet NGVD (or other FIRM datum -see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION "
Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level .
2(a). FIRM Znnes Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of I 11415171,3 J reet NGVD (or other FIRM datum -see Section B, Item 7).
(b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of I I I � i L feet NGVD (or other FIRM datum -see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is ul feet above '❑ or
below ❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W . LJ feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: la NGVD '29 ❑ Other (describe
under Comments on Page 2). (NOTE. If the elevation datum used in measuring the elevations is different than that used on
the FIRM (see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4 Elevation reference mark used appears on FIRM: 7 Yes 1 No (See Instructions on Page 4)
5 The reference level elevation is based on: IXJ actual construction construction drawings
(NOTE. Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.)
6. The elevation of the lowest grade immediately adjacent to the building is: 0L14-5fi—W feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
s not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: i _ feet NGVD (or other FIRM datum -see Section B, Item 7).
Date of the start of construction or substantial improvement
FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDMONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones At -A30, AE, AH, A (with 8FE),V1-V30,VE, and V (with SFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
s
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
T. W. Barrow RPLS # 1994
CERTIFIER'$ NAME LICENSE NUMBER (or Affix Sea)
RPLS �� W. Barrow SurvPvi ncT r'nmrnanv
TITLE
4
ADDRESS
Copies should be made of this
'Ar :.
T.'1Rf. BARROW
'� 1994 Q
NAME
Texas 76118
STATE ZIP
23-98 (817) 268-0200
DATE PHONE
official, 2) insurance agent/company, and 3) building owner.
COMMENTS: The Elevations hereon were taken from a Form Board Survey
there is no actual structure existing on this property. The FIRM
for the City of Coppell has been amended by letter from the Federal
Emergency Management Agency Case NO 94-06-105A This property is
now located in Zone "X" Map shows Zone "AE"
ON vam
ON mss.
S1A° sir
PIERS, OR WLUlws
A V A
A V
ZONES ZONES ZONES
ZONES ZONES
RE�lYIENCE
REFERENCE
LEVEL BASE
LEVEL
REPELLENCE
FLOOD
LEVEL
ELEVATION
•` s
OASE
FLOOD ADJACENT ''~< REFERENCE
ELEVATgN REFERENCE ADJACENT GRADE _ LEVEL
FL000
ELEVATION
LEVEL GRADE
The diagrams above illustrate the points at which the elevations should be measured
in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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