FEMA-EC940629The City With Aa.eutWFuture BUILDING PERMIT APPLICATION 0 1 ��
Building Inspections Dtvision
ILI 10, 2 q Print or Type in a Clear, Legible Manner
Job Address: 3 34 B r'o cK Date: M rk31 ! 9q q
Lot: Q Block: ' Subdivision: V I G CED AR. Phase or Section Number:
Owner: sty' t 1r1C. Address: Po Box Mo 0, e 11 Phone #: 3q3— 20%8
Contractor: SA Y" e- Address: Phone #:
Description of Work to be Done Class of Work: 54 New OAddition O Alteration O Repair El Demolition
--�-y _. a/ -, .--1 /1
of Building in Square Feet
First Floor 22 1 7
Second Floor 13'l Z
I L.
Garage -72--7
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.
Signature of Contractor or Authorized Agent Print Name
a;nM£(rEIeCJyj C. WEqED.MCCti,th�,.
Electrical Contractor Plumbing Contractor j Mechanical Contractor
SIR - 1 12!82)
Value of Work
to be Performed 2 $ q 00 0
GRAY AREA FOR
n
ELEVATION CERTIFICATE oM��3o6�-oor�
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 LOMB).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNER'S NAME
STREET ADDRESS (Including Apt.. Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
_334 -S7l0rcT-
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
L07- 1l1 A/r►,-u/ J2/,, nom, , -i, .—._ .Ao"
FOk INSURANCE COMPANY USE
POLICY NUMBER '
COMPANY NAIL NUMBER
CITY STATE ZIP CODE
7 ,r
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
d. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
9.4U"(in
AO Zones. udepth)
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: 1 L1 4918. A feet NGVD (or other FIRM datum -see Section B. Item 7),
qSECTION 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 _ / .
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 I I 141Q 181.0 feet NGVD (or other FIRM datum -see Section B. Item 7).
o(b). FIRM Zones V1 430, 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 I ,U 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 LL1. LJ feet above ❑ or
p below ❑ (check one) the highest grade adjacent to the building.
0, (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is L.1J . LJ feet above ❑ or below ❑ (check
�o one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
1Z 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: ❑ NGVD '29 Q Other (describe
under Comments on Page 2). (NOTE. H 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: U Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: 9 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 l l4191y1,L3 feet NGVD (or other FIRM datum -see
Section B. Item 7).
C'ER/TIFIER'S NAME LICENSE NUMBER (or Affix Seal)
1'74rr 4—R,0 we// 462 78
TITLE / COMPANY NAME
,ewe//JeP_y /74ri- �OWP- ..,Z,7c
ADDR CITY STATE ZIP
IRtol
SURVEY PLAT HR
LOT 10, BLOCK 1 OF BIG CEDAR ADDITION AN ADDITION
TO THE CITY OF COPPELL, TEXAS.
F� oaD why .Es /t�'
T
— 3p— UTIL'—ESMT. �
P�PoPc:sE p F4
l iN� P,E aOp PLq��/
CP
34.9
13.7 u�
N
17.5
ti
co FORMBOARDS �'1
d 11.4
01 ,B
Ip.S ci 14.0 dM c
11.2 13.6 '3c'
^Vi�
ytiEpD4l.lrSO MM 40 \
/C 1`
_3. 34 BR®CK STREET
1 hereby certify that on the 16TH day of JUNE 1994 , this survey was made on the ground as per the field notes shown n this survey
and is true, correct, and accurate as to the dimensions of the subject properties original monumentation or replacement of that thereoof
The survey shows all easements and visible easements of which 1 have been advised of affecting the subject property
Reference bearing shown in parenthesis.
Date : JUNE 29, 1994
G LEGEND
1/2" Steel / Iron Rod Found Q
1/2" Steel / Iron Rod Set
Property Line
Wood Fence
Chain Link / hire Fence x—x—x—x —x
Overhead Electric -- E-- E-- E—
GF No.
Scale: I"= 25'
By77
OF
HARRY J. ROWELL )
4597
JOB#:�41
HARRY
ROWELL
& Associates, INC.
Surveying do Engineering
1301 Elm Street Ste. 201
Carrollton, Texas 75006