FEMA-EC011004The City With A Beautiful Future
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BUILDING PERMIT APPLICATION
fl) q / / Print nr Tvne in a Clear. Leoible Manner �W/ M '91 A/l �.. 4m
Job Address:�J 3 r fi�r�
Date:
Lot: Block:C /irSubdivision: Ca tA
Phase or Section Number:
��S
Owner �S Address: L' %�-
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�l / Phone #:
Contractor: Address: �
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L V )� SPhone #: 72
Description of Work to be Done Class of Work: New ❑ Addi ion
❑ Alteration ❑ Repair ❑ Demolition
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Area of Building in Square Feet
First Floor O� /� -� Garage ��
Second Floor 1270 Other
Value of Work
to be Performed�� O
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Feer
Receipt Number:4 ;t 9q tall i
Zoning District:
Occupancy; Classification:
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.
Approved By:
Dale:
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 goveming this type of work will be
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
Comments.complied
legulati construction of the performance of construction.
It- 6Qq4
jSi ure of ontractor or Authorized Agent /�+ Pfrint Name `
Ate- /IIS-OMO (..,r7`'/azf��
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
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F
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Read the instructions on pages 1- 7.
O.M.B. No. 3067-0077
Expires July 31, 2002
SECTION A - PROPERTY OWNER INFORMATION I Forir arae Carpem Use:
• BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.I Company NAIL Number I
533 CARTER DRIVE
CITY STATE ZIP CODE
COPPELL TX
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 5 OF CARTER ADDITION PHASE 11
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
##• - ##.#r or ##. ) ® NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ® Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & CO AMUNITY NUMBERI SNTY NAME I TW. EXAS TE
COPPELL 480170
B4. MAP AND PANEL
135. SUFFIX
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUMBER
B6. FIRM INDEX DATE
EFFECTW- REVISED DATE
B8. FLOOD ZONE(S)
(Zone A0, use depth of floc ft)
0010
E
03-08-74
04-15-94
AE
465
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile ® FIRM ❑ Comrnunity Determined ❑ Otw (Describe):
B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings' ® Building Under Construction' ® Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1(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 AX AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3. -a4 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 ConversionlCorrxments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No
o a) Top of bottom floor (including basement or enclosure) 471 90 ft(m) m Tr
o b) Top of next higher floor — _ft.(m) co
o c) Bottom of k>west horizontal structural member (V zones only) HARRY J. ROWEI.t-
o0
o d) Attached garage (top of slab) — _Nrn) 10.1 c �„ ...�� 9*"
W m
o e) Lowest elevation of machinery and/or equipment m
servicing the building (Describe in a Comments area)E 16 e' ��r►�*�0�.
o f) Lowest adjacent (finished) grade (LAG) _. ---ft -(m) z05 S(jR
o g) Highest adjacent (finished) grade (HAG)
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 8
J
o i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. an)
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.
1 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.
CERTIFIERS NAME HARRY ROWELL LICENSE NUMBER 4597
TITLESURVEYOR COMPANY NAME HARRY ROWELL COMPANY
ADDRESS CITY STATE ZIP CODE
1301 ELM STREET STE. 201 CARROLLTON TX 75006
SIGNATURE DATELEPHONE
TE
i (972) 242-5679
FEMA Form 81-31, J
SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS