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FEMA-EC980914AW mp--r421 1 S BUILDING PERMIT APPLICATION Print or Type in a Clear, Legible Manner INS�C Job Address:/c277� Q�� Date: Lot: /r Block: Subdivision: �''P'�I A Phase or Section Number: Owner Address: ;�Phone101 ,p Contractor: Address: t 1 Phone #: Description of Work to be Done Class of Work: O'l�iew ❑ Addition F-1Alteration El Repair El Demolition � 5/ Area of Building in Square Feet First Floor1Garage Value Value of Work � L�l,�J to be Performed � � �� y Second Floor �� OtherR&-t4-�� GRAY AREA FOR OFFICE USE ONLYANN NOTICE x➢ O 4A This permit becomes null and void if work or construction authorized is not commencedu within 180 days, or construction on work is suspended or abandoned for a period of 180 days ti at any time after work is commenced.Mm e g� e I hereby certify that 1 have read and examined this application and know the same to be true. NO m g and correct. All provisions of laws and ordinances governing this type of work will be �� 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 - 2 q a s� x re Matin construction of the performance of construction. g t . 5:2— �� ta Signature of C;-ntACtjr or Authorized Agent Print Name C� rEzT G�►LLV� S�rtv�� ,, .m„�b r� Electrical Contractor Plumbing Contractor M hanical ContractorIn �� 01 �WIN FPMC - 1 (4/94) "7--r0 &/ 14— F L- 9 7,-L-%,3 ,Q Y7k .-- BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, 5-Y CUSTOMER - PINK O.M.B. NO. 3067-0077 ELEVATION CERTIFICATE Expires May 31, 1996 FEDERAL EMERGENCY MANAGEMENT AGENCY 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 provide 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). 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 POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY NAIC NUMBER 12-75 OTHER DESCRIPTION (Lot and Block Numbers, etc.) _ Lo T i to l3c.s��-1�- P� l��lE3Z�� 9 6E Act�D lTrOtii ' CITY STATE ZIP CODE Com+ PC—U._ TE�i� 5 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER . PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION /�E (in AO Zones, use depth) 4-Sb1�1O oo►O C SL is ��q 44&.D 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: L 1 1 I 1 J.0 feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and that best describes the subject building's reference level pt- FOZAS 2(a). FIRM Zones Al -A30, AE, Ali, and A (with BFE). The top of the reference le el iii from the selected diagram is at an elevation of I 1 14107 . LII feet 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 levet from the selected diagram, is at an elevation of I I l j I l .LJ feet NGVD (or other FIRM datum—see Section t3, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LLLLJ 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 Ll_ I.H 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? RYes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ 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 71, 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: L�1 Yes ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on: 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 cerlific,-da will only be valid for the building during the course of construction. A post -construction Eb vation Certificate will be required once construction is complete.) f 6. The elevation of the lowest grade immediately adjacent to the building is:l I 'Lv L5� . feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicatud in Section C, Itern 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the ielevation of the building's "lowest floor" as defined by tho ordinance is: Ll. 1 .1.1_1 1 feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 61.31, MAY 93 REPLACES ALL PREVIOUS EDITIONS . SEE REVERSE SIDE FOR COI MNOATION fa 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 Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) 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. Referenca level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to ceftify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Features) not `included in the certification unuur Comments below. The diagram number, Section C, Item 1, must still be entered. ' 1 certify that the information in Sections B and C on this certificate represents my best efforts to i rpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 1 ection 1001. 1p�'ri%9 s, rFn•:�"�w CERTIFIER'S NAME LICENSE NUEFit0 Allix TITLE COMPANY NAME c�c .....................�. ADDRESS CITY STATE ZIP Si- AT DATE NG opies e d b made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ON ITH SLAB BASEMENT ON PILE., PIERS, OR COLUMNS AV A A V ZONES ZONES ZONES ZONES ZONES REr❑iENCE -_ �\ HEFENGNCI. LtvEL ,ASE LEVEL - HEfCftENGE FLOOD LEVEL TI[VATION it _ �•�_ i BASE l" aASE FLOOD AUJACFNi r.: fiEFE..HENCE FLOOO ELEVATgN � GAADE ti_; FiEF+hl:�u,E AD�A:.ENT �; It VEL ELEVATION Ll AU[ -�y ADJACLIA >. The diagrams above illustrate the points at which the elevations should be me,Js,ured in A Zones and V Zones Elevations for ;;.I A Zones should be measured at the top of the reference levL.i ttoor. Elevations for a i '.' Zones should be measured at the bottom of the lowest horizontal structural member. P-Jge 2 1 �j j �J f-' `✓ E Y PL/ -'J BARRY S. RI l f ,,, ;i tered Pr ofe,: z>incil I_,�nd urweyc:>r (972) 475-8940 Thtis is to _-crtify treat persons under n -i\, direcAlon "Pf have, this date, mode a careful and "Ccurote suf vr o �, r'. the ground of ol: erty locat'-d at. 1 275 BRADFORD DRIVE in the iity of _ (OPPf_.L- (ex( _ described as follows: LOT 16, BLOCK; A, CiF RIVERRIDGE , All ADDITION 10 THE CITY OF CQIPELL, DALLAS COUNTY, TEK:V , ACCORDING TO THE __ RECORDED IN _, PAvE , OF Tl iE RECORDS OF DALLAS COUNTY, TEXAS. TEXAS.E o.RG-. C %.r 0 The plat hereon ie o representation of an on the ground Survey as datev d theveaboe, the lines and dimensions of said prcpe:�rt being as indicated by the plat; the size, location, anct type of buildirl _ and inprcvernentss are as spawn, all improvements being within the boundaries of the grope = �� back from property lints tl,- distances indicated. I l '�..•'CjT� THERE ARE NO ENCROACHMENTS, CONFLICTS OR PROTRUS,10 S �.so 'tom SCALE: I HIS SURVEY WAS PERFORIv1F.D E c: LU IVEL_Y' FOf' '••S• • ' .�:,.. DATr=: 09!_ 4'' UMEER HOME` BAr7rS ES — - -- I r 'E ,r ]-HIS S SL IPVr Y Fl iR 411 ''I �r R PUR-'C>SE v F. c''..o. , Jr�Li jr 1h� I STI iEF PARTIES ti SriAI _L t L AT ! it IF? r<rS — — - - dDLR ,GNbCJ I I. I r i�l I i� f0! SIQ ANI .--- - - - U