FEMA-EC940210W4W a«Writer
BUILDING PERMIT APPLICATION
D 3. 2- q Print or Type in a Clear, Legible Manner
Job Address: Qrocy, Daft' l—A7- 94
Lot: Block: ' Subdivision: G OE' D Phase or Section Number:
Owner: J N( street Z+ne Address: Pc ! 3(.4�0 1( Phone #: 3 y' -.2 -78
Contractor: 5 A W E Address: Pbone #:
Description of Work to be Done Class of Work: New ❑Addition ❑ Alteration ❑ Repair ❑Demolition
ShMILE filmic,y 2654CA160
of Building in Square Feet
First Floor .2"b
Second Floor 1330
Q11"16D
Garage 7$s
Other
Ibis permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work is suspended oe 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.
JI
Signature of Contractor or Authorized Agent Print Name
Mi& ElecfR.tG• di a P 'h 6rA6r-hdn icj
Electrical Contractor Plumbing Contractor J Mechanical Contractor
BIR - 1 12/92)
Value of Work vo
to be Performed ,jn&Y'0o.
GRAY AREA FOR OFFICE USE ONLY
°.'".e'!b3o6'-°°"
ELEVATION CERTIFICATE :
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 ensurecompliance 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.
SECTION A PROPERTY INFORMATION
BUILDING OWNER'S NAME
STREET ADDRESS (�MGudirp Apt. Unit, Suit and/or ". Number) OR P.O. ROUTE AND BOX NUMBER
Block
OT/ IL- E 7 (Lot 8/O /� /tubers, etc.)/ G' �c�dG ✓ /-,��� �,',., ✓l
CITY
STATE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
FOh INSURANCE COMPANY USE
POLICY NUMBER
COMPANY NAIC NUMBER
ZIP CODE
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZO E
6. BASE FLOOD ELEVATION
(in AO Zones, use depth)
r. indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ®"Other (describe on back)
S. 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 I . U feet NGVD (or other FIRM datum—see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
W1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
v describes the subject building's reference level
W 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
V� �''bf 1 1 141g 171. feet NGVD (or other FIRM datum—see Section B. Item 7).
(b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
o the selected diagram, is at an elevation of L I I I I I .LJ 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 L1J . LJ feet above ❑ or
O 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 L1J . LJ feet above ❑ or below ❑ (check
Oone) 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
0 3. Indicate the elevation datum system used in determining the above reference level elevations: 11NGVD '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: ❑ 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: L_14191 Lg feet NGVD (or other FIRM datum -see
Section B. Item 7).
C''ER//TIFIER'S NAME LICENSE NUMBER (or Affix Seal)
/7U rr 4 fFo141CII 46 Z 7 g
TITLE // COMPANY NAME,�1
leng/Ae _ / /7grr �DweI�3 /7SsoG ZIC
ADDRLIS
�� /� CITY STATE ZIP
130/ .E/�jq �OTr ICe C.4rra/�fDi9 . TY. 75006
SIGNATURE _,4f,_ �� DATE PHONE
1An
SURVEY PLAT H R
LOT 7, BLOCK 1 OF BIG CEDAR ADDITION AN ADDITION
TO THE CITY OF COPPELL, TEXAS.
a
75.64
LOT '7
BLK 1
0.324 AC.
0 YEAR FLpOD
X4.9
M
4I
4.3
N
0
00
CAD4
O
O.V 26.6
F-� 19.3 8.d
C4 I �-
Ir o
14.s
LOT 6 N FORMBOARDS �
,� ly LOT 8
2.8 N 11.9 2'
13.0 lion 14.3
25' BLDG. LINE
'90. o
In I
5' UTIL. ESMT. —I
(S 39639'30" W)
75.00
....
---.... .
ROCK........
325 S R E E T
I hereby certify that on the IST day of Feb. 19 94 this survey was made on the ground as per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and size, location and type of buildings and improvements thereon,
if any. The survey shows all easements and visible easements of which I have knowledge or have been advised affecting the subject property.
There are no encroachments, conflicts, or protrusions visible on the ground other than those shown. Reference bearing shown in parenthesis.
�fG GI 8 it
Date February 10, 1994 4'��'�`�1 Rudy
JOB
HARRY J. ROWELL }
GF No. 4597 ....
LEGEND- q) H
1/2" Steel / Iron Rod Found O
1/2" Steel / Iron Rod Set
Property Line
Wood Fence — - — — —
Chain Link / hire Fence x — x — x — x — x
Overhead Electric -- E E E—
Scale: 1 = 25
By :
ARRY
ROWELL
k Associates', INC.
Surveying At Engineering
1301 Elm Street Ste. 201
Carrollton, Texas 75006