FEMA-EC970220 (2)C1The City With A Beautiful Future
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BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
i, D D
rFrJA2 1997
Job Address:
Date: -F
Lot: O Block: Subdivision:
J Phase or Section Number:
Owner Address: �A
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(it' I
C="`/t
Contractor:'1f
Address:
Phone #:
Description of Work to be Done Class of Work:Q'/New ❑ Addition
❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floor I , G 38 Garage 0 I
Value of Work
990100
Second Floor I Other ° �2J
to be Performed
02 Z 5F
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee: /
Receipt Number: 514 33'}-2,
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
Zoning District:
Occupancy Classification:
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
Approved By:
.r Cate:.
Comments:
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.
if
Signature of Contractor orrAu_tho`rizedj Agent Print Name
✓
Electrical tr c r Plumbing o tractor Mech ical Contractor
FPMC - 1 Will -
2)-97
O.M.B. NO. 3067-0077
• ELEVATION CERTIFICATE Expires May 3i, 1996
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 J FOR INSURANCE COMPANY USE I
BUILDING OWNER'S NAMEI POLICY NUMBER I
Drees Homes
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY NAIL NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
KMPPMXX Lot28 , Block A, Copperstone XH-NX X
CITY STATE ZIP CODE
Coppell Texas
SECTION B FLOOD 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
5. FIRM ZONE
6. BASE FLOODELEVATION
(in AO Zones, use depth)
480170
0010
E
LOMB 1/25/95
1
X
1
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): X I NGVD '29 f__1 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: I I I LIJ . LJ feet NGVD (or other FIRM datum—see Section B, Item 7),
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 _l__ .
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 LJ_II .0 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
the selected diagram, is at an elevation of [._1_1.__l_.L_I.I_l 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 I_ I) .I feet above or
below F] (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 .I I feet above I I or below I (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? [--I Yes [_ I No LI Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: Ll NGVD '29 f 1 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 8, 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: FK1 Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: actual construction [ _1 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.._L_7j_,_ j feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: L1 j_1_ 1_� .L ._I feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
If certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal)
Richard C. Maki Tx. Req. 4587
TITLE COMPANY NAME
Reg. Prof. Land Surveyor Maki and Associates, Inc.
ADDRESS CITY STATE ZIP
3521 W. Pioneer Parkway Suit:, Arlinqton Texas 76013
SIGNATURE DATE PHONE
�''i✓i� 2-20-97 (R1 7 1 77d—FRRI
should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: According to the HUD Flood _Insurance _Rate Map, _ Comm. _Panel No._________
480170 0010E, revised to reflrct LOMR dated Jan. 25, 1995, this lot is
in Clear Zone X. The recorded plat for Copperstone shows a Min. Finish
Floor Elevation requirement of 464.9 feet, a vertical control survey
determined the finish floor elevation of the wood forms on this lot to
be 468.45'- Bench Mark: RM 196, Elev. 467.22'.
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A v A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE BASE LEVEL
REFERENCE
LEVEL FLOOD
LEVEL
ELETATION
i
BASE..
' ADJACENT:: FREFERENCE1
BASE
FLOOD
FLOOD
ELEVATION REFERENCE ADJACENT GRADE LEVEL
i
ELEVATION
LEVEL GRADE
.:.:::::::::.:'.:::::'. :::...
ADJACENT::.
�n.:•;:.:::
GRADE.
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2
• PROPERTY DESCRIPTION
Lot 28, Block A, COPPERSTONE, on Addition to the City of Coppell, Dallas
County, Texas, 'according to the Plot recorded in Volume 96013, Page 87,
Mop Records, Dallas County, Texas.
Lot 27
S 31 '10'51 " E
: I•
F=500.00 L=85.
32,6 60)0)01',P5'TOiYE Ti?,4/L
Center line control monumentotion found
was used for cintrolling rnonumentotion.
I, the undersigned, hereby certify that the survey map hereon, and
the accompanying description, depicts and describes the resulh, ul
a careful and accurate survey, made on the ground, and to the best
of my knowledge and belief, is a true and correct depiction and
description of the property surveyed, and that there are no
apparent encroachments or protrusions across boundary lines,
shortages of area or boundary, except as shown hereon. The only
easements the undersigned hos knowledge, are those as shown,
however this property is subject to any and all easements,
reservations, and restrictions that may be of record. Any
reference to the 100 year flood plain or flood hozard zone, is an
estimate based on the data stated hereon, and st ould not be interpreted
as a study or determination of the flooding propensities of this property.
Note: This survey was performed in connection w th the transaction
described in:
Form Survey, for Drees Homes ( Att: Andy )
DIVA J AM) lfl ri,
P.O. BOX 14293 ARLINGTON, TEXAS 76094-129.3
( 817 ) 274-6883, Metro ( 817 ) 261-8138
Legend: O Iron Rod Found —x—x— Wood or Wire Fence
0 Iron Rod Set � Control Monurnent
\\ All iron rods are 1/2" rebor unless otherwise noted.
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Richard C. Maki
Registered Professional
Land Surveyor No. 4587
Dote: 2/03/97
job No. 1681 1 —3P:?
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