FEMA-EC940114The City With A Beautiful Futuro BUILDING PERMIT APPLICATION De 1 3
Building Inspections Diltision
.L Print or Type in a Clear, Legible Manner j
Job Address: Date: 1a
Lot: Block: A Subdivision:1 LS� phase or Section Number:
Owner: t , Address: Phone #:
IN , l 2 775Z)
Contractor: Address: Phone #: / " l 7
Description of Work to be Done Class of Work: ❑ New ❑Addition ❑ Alteration ❑ Repair ❑Demolition
<:� -- rrA Alp
Area of Building in /Square Feet
First Floor. / �Garage �' v
Second Floor 3 Other
NOTICE
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 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
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
regulating construction or the performance of construction.
BIR - 1 12/82)
Value of Work
to be Performed (�
Y AREA FOR OFFICE USE
ELEVATION CERTIFICATE' O.M.B. N03067-0077
FEDERAL EMERGENCY MANAGEMENt"AGENCY Expires May 31, 1993
NATIONAL FLOOD INSURANCE PROGRAM ,
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purch4se 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 Amenrlrilaht or Revision (COMA or LOMR).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION ` FdR INSURANCE COMPANY USE
BUILDING OWNER'S NAME P&ICY NUMBER
WESTCHESTER HOMES
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
880 BRENTWOOD ;
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
,OT 46 BLOCK A. VTT.T.AGES OF COPPFTT HASP TTI
CITY
COPPELL STATE TEXAS ZIP CODE
al. SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the fol l gvlli ;'tfbm the proper FIRM (See Instructions):
I. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
480170
0010
D
10-16791
AE
(in AO Zones, use depth)
450.00
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 1:4NGVD '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 I I I .Lf 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 6 that best
describes the subject building's reference level 1_ .
2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of 181 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 1evQI from
the selected diagram, is at an elevation of L_l_L_L_ A 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 LLJ.LJ 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 IAA. Ll 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? F-1 Yes L] No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: L4 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 7], 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: _� Yes No (See Instructions on Page 4)
5. The reference level elevation is based on: ❑x actual construction Ll construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference levdl flo lace, 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: L_L_L 451614- 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 indicated. in Section C, Item 1
is 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: L._L_I_L_LJ .l._ I feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81 -3 1) MAY 90 REPLACES ALL PREVIOUS FDi I IONS 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 Ai—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 Zone§ 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 �L,.rpust still bee eyed.
1 certify that the information in Sections B and C on this certificate represents my best efforts to in th$ta e.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.'�1 Tf
CERTIFIER'S NAME
ROLAND RODRIGUEZ
h 4�0 R�• �9
LICENSE NUMBER (or A R LAND RODRIGUEZ
TITLE COMPANY NAME -►av r •
MANAGER JAMES H. DOWDY -LAND SURV OST O
---- -- (Ary •�w ZIP
ADDRESS K S"
1550 N w o D�. S i e 410 Hurst 70054
SIGNATURE DATE PHON
1-14-94' (817) 589-7107
Copies should be made of this Certificate for: c munity official, 2) insurance agent/company, and 3) building owner.
COMMENTS: The following Benchmark was used in determining referenced
elevation- Top operating nut of fire hydrant located on East side
of Allen Rd. 1001 North of Chalfont Place.
Elevation- 456.93 ft.
Source- Shown on Subdivision Plat recorded in Vol.92218,Pg.3565 DRD'CT.
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL
REFERENCE
REFERENCE BASE
LEVEL
LEVEL FLOOD
ELEVATION
�':•
BASE
S:. :;::::`:'i'::.`' •.:.n,'*
BASE ADJACENT:;'?�t$, REFERENCE
FLOOD
ELEVATION
FLOOD GRADE "�" LEVEL
ELEVATION REFERENCE ADJACENT A,
LEVEL GRADE
,•!:`•i::': ;:.; .: .`•; �.:'.<�:; :'::.'v�;:'.. ::'1i•,
ADJACENT :,
y.;.,..�.;
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.
Page 2
REFERENCE NO: 39971
LOT 46, BLOCK A, VILLAGES OF COPPELL PHASE III A, AN ADDITION TO
THE CITY OF COPPELL, DALLAS COUNTY, TEXAS,
FORM SURVEY
15' BUILDING
LINE DEFOREST DRIVE
1/7' I.R. FND. 1/2" I.R. FIND.
S.89°44'05" E. 62.0'
10' GTE ESM'T
}----- --- — 15' ALLEY
LOT 46
00 0.16 ACRES /
0000
t o' cr1
C)
w o
Q
o Ln I cn 45
u (f
O
z C�
WZ MI 1 FORMS 1�
Q 1 to I
15' BUILDING
--16.2' I LINE
oN\ 1
d^'c�-ll
11 11 \
N.89'44'05"W. 61.27'
1/2" I.R. FND.
1/2" I.R. FIND.
880 BRENTWOOD DRIVE
SURVEYORS CERTIFICATION
r.Fr_FArn
FENCE OVERHEAD ELEC.
3F— E —
TELEPHONE
— T —
CONCRETE.
BRICK—=WOOD=
STONE
r{ DECK
OCCN DECK
R.R. TIC RETAINING WALL
rrzr
D RICK WALL
rON WA66
k= (CONTROL MONUMENT)
The undersigned Registered Professional Land Surveyors certifies that; (A) this plat of survey ant the property description set forth heron are
a true and correct representation of facts found at the time an actual on—the—ground survey; (B) such survey was conducted by the surveyor, or
under his supervision; (C) all monuments shown hereon exist and the location, size, and type of material are correctly shown; (0) the location
JAMES H. DOWDY & F', 0 LA Ni D R;9i:;! .:.
JAMES H. W 2
ASSOCIATES, INC.
1550 NORWOOD, SUITE 410 °
HURST, TEXAS 76054 12-29-93 ROLA RODRIGUEZ, R.P.L.S. No. 49 ft;- 00W4 r
THIS SURVEY NOT VALID WITHOUT EMBOSSED SEAL & ORIGINAL SIGNATURE SUN,
I -------------- -�
I �n My
I"=2G7'
I �I
- I I
� I t
t
41
4662; 1 -�-�z ry=�
1 f
15 �L
I I IN1MUM
i
I FORM BOARD
t `�\ L — — — — SURVEY REQUMED
tQ '
>�n
COPPELL
REVIEWED
— a7�
BYDATE
Approval of the pla and specifications shall rrot
�� construed to mean construction in direct con -
with the City of Coppell Building Codes and
Zoning Ordinances.
LOT 46 5LOCX A
V1LLACv5 c� COFFELL PHA51! I11 A
GUPPEI. L, TEXAS
10-29-1993 07: 02AM P.02