FEMA-EC000615C
-Am ae4a0V
// //
BUILDING PERMIT APPLICATION
11065. Z/ Print or Type in a Clear, Legible Manner
Job Address: lam/ / is C ��/T
Date: Za a0
Lot: Block: 6r—Subdivision:
4��wo P44.01,-
Phase or Section Number:
Owner Address:
Phone ti:
Contractor:4::fL4ra w, XL(&,,/ Address:
C �X Z % i�
Phone #: S`� Z _
Description of Work to be Done Class of Work: F9\New ❑ Addition
❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floor aq6 7 9, Garage
Second Floor eqq Other
/� n
Value of Work
to be Performed 4 4M
C1%L
7 S GRAY AREA FOR OFFICE USE ONLY
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 autho it to violate or cancel the provisions of any other federal, state or local law
regulati constru n of th ance of construction.
Permit Fee: ?
Receipt Number:
Zoning District:
Occupancy Classification:
Approved By:
Dater
Comments:
Signatu of Contractor or Auffiorized Agent Pfrri�intt `Name
�1,iafll7r G5
Elect cal Contractor Plumbt IContractor Mechanical Contractor
-
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
r -
J
Q
FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING STREET ADDR SS (InGuding Apt., Ugit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
�o/S �O'le unT �9r7�
CITY STATE ZIP CODE
Numbers,
, etc. Use Comments section if necessary.)
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1-1 GPS (Type):
( ##° - ##' - ##.##" or ##.###W) I V6AD 1927 1_1 NAD 1983 1_1 USGS Quad Map 1_1 Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE
Co/°PzeeL 480/ 7 e
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
DATE
EFFECTIVE/REVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
00/10
46-
w
servicing the building
x'
B10. Indicate the source oft Base Flood Elevation (BFE) data or base flood depth entered in B9.
—I FIS Profile 1_1 FIRM 1—I Community Dgtermined 1_I Other (Describe):
611. Indicate the elevation datum used for the BFE in 69: 1—I NGVD 1929 1-1 NAVD 1988 1_1 Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes 1_1 No
Designation Date:
SECTION C - BUILDING ELEVATION INFO ATION (SURVEY REQUIRED)
C1. Building elevations are based on: 1_1Construction Drawings' I V Building Under Construction' 1—]Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number _ / (Select the building diagram most similar to the building for which this certificate is being completed -see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used app
❑ a) Top of bottom floor (including basement or enclosure) 4(0(0
.-ED(m)
❑ b) Top of next higher floor 46
/ ft.(m)
ti
❑ c) Bottom of lowest horizontal structural member (V zones only)
❑ d) Attached garage (top of slab)
_ ft.(m)
$
❑ e) Lowest elevation of machinery and/or equipment
w
servicing the building
_ ft.(m)
❑ f) Lowest adjacent grade (LAG) 4(e(e
ft.(m)
z'tn
❑ g) Highest adjacent grade (HAG)
ft.(m)
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
❑ i) Total area of all permanent openings (flood vents) in C3h
sq. in. (sq. cm)
v* --q
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
t certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME r / n / LICENSE NUMBER
TITLE / COMPANY NAME
'5 . r via v or / e� ,-r.� O tve,`% �om.Dan .
ADDRESS D/ -AV Im % e `i CITY PYO Oh / 75'� (p ZI CODE
SIGNATURE_ DATE TELEPHONE
-00 C972Z-SG
FFKAA Fnrm 111-11 At Ir; Qq/"/ CFF PF\/PPCF CIr1F Fr1P r.ONTINl IATION PFPI Ar .FC At 1 PRF\/Irll IC r-nITIr1NC
SURVEY PLAT
LOT 4 BLOCK E OF MAGNOLIA PARK AN ADDITION TO THE CITY OF COPPELL DALLAS,
COUNTY TEXAS REC. IN VOL. 98145, PG. 506, P.R.D.C.T.
LOT 3
13.7
R = 496.20'
123.68
w
0
N
e7
�--
89.66
R = 360.00'
FND. P/K NAIL
I
13.8 I
I
12.1
I_- I LOT 5
6 15 CAT�i TJ
0TN'T ]LANE
HR
1 harehv certih that on the t 5Tfl day or .n N F 20 uU thio survey we made on the ground and this survey plat has been prepared as per the field
I!,, ➢rreby 1 .:, r e,! and it pn _i, rrpn•ven to U„ la, ! : as ;o,n:u on .h,• 4, uW:d ';;oi plai hila becu prepared in accordance with, and in
l:
�c- r ri'h ,all r•,Irs and n'Rulafions rromnt::-: eel L} in,- 1, -,:-s b.,.»rA n( 4'rufr e.:oual Land ;iurvel in g. Uulese otherwise noted. the
snrvevor hes relied scl,Iyon the record data providrd in the titre cn unn;Unrnl fur 11, d leen mnL•-.rn of the hen r:.htricS of I.tte land parcel surveyed and for
anv raermmlts
of r,,-crd whL-h may be shown or addressed no Ute surve..y. The survey shows vishle easements, encroachments, conflicts, or
protrusions apparent on the ground. -_
OF
Date JUNE 19, 2000 i,rs,Pe�ry JOB 00-3370
® LEGEND 0
1/2" Steel / Iron Rod Found O
1/2" Steel / Iron Rod Set
Property Line
Wood Fence — — - — — — —
Chnin Link / Hire Fence x—x—x— x—x
Overhead Electric — F.— E E—
�,
.:.................:..
GF No. HARRY J. ROWELL
.........................
4597
Scale: 1" = 25'qO1 ,o4J/
SUR�j'
�J
ff
HARRY
ROWELL
& Associates, INC.
Surveying & Engineering
1301 Elm Street Ste. 201
rollton, Texas 75006 (972) 242-50'
C;IT.y ()F- Ir.0ppEtJI
124.9*1
oval Of tm Cal"
ru to** amw Z0*q
of
Ord
cc
.I*OF
Tn
Gao Residence
Lot 4 / Block E
Magnolia Park
Coppell, Texas
Clements -Allen He
0
0
A N E M 0 U N T L A N E
FE M.A_ E Jt
'Iff -
mum LL /pyl) Plot Plan
SCALE lNn20'-0"
XAqRETE
RIVEWAY
Emmimlow-111rd
M