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FEMA-EC9506147The City With A Beautiful Future BUILDING PERMIT APPLICATION Villy c j Print or Type in a Clear, Legible Manner Job Address: Date: � Lot: Block: Subdivision:,F�.iL ©!['rA,,4 d rt . ' f 1t1~Section Number: Owner Address: 0, 3o Contractor: �v7�@/� Address: 3y� t � 640- -Phone #: �1 7 —3V3- t/ F` Description of Work to be Done Class of Work: New ❑ Addition El Alteration ❑ Repair El Demolition Area of Building in Square Feet First Floor 7- 5-3'4) Second Floor 1 1 1d NOTICE GarageIO ZZ Other 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 of the performance of construction. —'--- 3tgnature of Contractor or Authorized Agent Print Name Cf. B �.ee�i�' I�l�t.jc�2 �3Lyu. Alp-,q%4,46rS/c�'�4G Electrical Contractor Plumbing Contractor Mechanical Contractor Value of Work L5 Q�G� G to be Performed f 7 GRAY AREA FOR OFFICE USE ONLY FPMC - 1 (4/94) 01/ W -f�0�—v czt g'ff O.M.B.rosos�-aon 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 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. SECTION A PROPERTY INFORMATION I FOh INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIL NUMBER OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY, - w _ _ w . - STATE ZIP CODE SECTION B - FLO(OD 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 460170 00 �o 46 4 -�s• q� - �} (in AO Zones, use depth) 45"Z 7, Indicate the elevation datum system used on the FIRM for Base Flood'Elevations (BFE): ERNGVD'29 ❑Other (describe on back) 3. 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 . L feet NGVD (or other FIRM datum --see Section B. Item 7), �— 7-0P of 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 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 114 617' AAJ feet NGVD (or other FIRM datum -see Section S. Item 7). (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 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 W .L 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 LLJ . U 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: ❑ NGVD'29 Q 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: 19 Yes ❑ No (See Instructions on Page 4) 5 The reference level elevation is based on: Or 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: I I W I514 I .�-_1 feet NGV datum -see Section B, Item 7). CERTIFIER'S NAME LICENSE NUMBER (or Affix SiFoilfd� ''// p /74 rr je r7 06V e ll 4lp .� 7 6 JAMES TITLE COMPANY NAME o 0tfowCILL .�/� wet .; els a _Z �� a 4 ADDRIMS CITY ens•. /S ® ZIP /3a/ .E/ �e� C -q o 73. 750,06 s'o SIGNATURE DATE t 14) 242-6617q 1A) R- U, IA). PLOT PLAN _4 ,C,,L.E. V . 20' TWE ESTATES OF: CAMBRIDGE MANOR LOT 5 5LOCK E DALLAS COUNTY COPPELL, TEXAS IlZ ZZ171,7Z,1 lSURVEY PLAT R LOT 5, BLOCK E OF THE ESTATES OF CAMBRIDGE MANOR AN ADDITION TO THE CITY OF COPPELL, TEXAS. WV �»_ - 1~ 0 � N LOT 5 D L K E 27.9 ,g 7.2 , IV 10.5 6 1 FORMBOARDS 3.3 �1 9.8 O i 5.0 � 5.3 0 10.1 11.4 �n rn 5.3 14.1 4.3 12.7' LOT 4 _ o DDo �'7.5�tll­ ESMT. X00., CALLEJj COMMON AREA DRAINAGE ESMT. '-t CAMBRIDGE MANOR LANE l 1 hereby certify that on the z 1 h..day of .JU E, 1995 , 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 properly and size, location and type of bdildjngs and improvements thereon, if any. The survey shows all easements and visible easements of which 1 have knowledge or have been aNseA,' affecting the subject property. There are no encroachments, conflicts, or protrusions visible on the ground other than those shown. / Q��OF I,I STki?- �- Date J1;NE 14, 1995 �� �� JOB# 95 2_79 ..............-- HARRY J. ROWELL} .. ............ GF No. — 4597 G ^ P DD--- - � LL 11� A� 1�Y 1/2" Steel Iron Rod Found O I /2" Steel / Iron Rod Set Property Line Wood Fence -- — i'hain Link ,/ hire Fence Overhead Electric ---- E-- — E-- E -- Scale: V'= 25' S1TR By ROWELL & Associates, INC. Surveying & Engineering 1301 Elm Street Ste. 201 Carrollton, Texas 75006