FEMA-EC9704237Thety with A Beautiful Future BUILDING PERMIT APPLICATION
S �' )-I Print or Type in a Clear, Legible Manner
Job Address:, c`%TCt
DEPT
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ETION
Lot:Block: Subdivision:
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Phase or Section Number:
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Owner,. Address: q % y 1 ter, F�7� .� Phone #:
Contractor:Address:
(,Y)
Phone #:
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Description of Work to be Done Class of W�rork: ,New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
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Area of Building in Square Feet
First Floor. Garage
Value of Work
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to be Performed-'✓
Second Floor Other
d 5
GRAY AREA
FOR OFFICE USE ONLY
NOTICE
,A
Permit Fee:/
Receipt Number:
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.
Approved By:
[date:
I hereby certify that I have read and examined this application and know the same to be true
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
Ica
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction of the performance of construction.
n
ig azure of Contractor or Authorized Agent Print Name
= "r—�,4t!r F rNr-rl
Electrical Contractor Plumbing Contractor Mech ical Contractor
FPMC - 1 (4/94)
O.M.B. NO. 3067.0077.
ELEVATION CERTIFICATE Expires May 31, 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 ComrTiunity 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
Drees Homes
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
4_30 Copperstone Trail
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
_K9PP1= Lot37, Block A, Copperstone
CITY —
FOR INSURANCE COMPANY USE
POLICY NUMBER
COMPANY NAIC NUMBER
TXXXXX
STATE ZIP CODE
Coppell Texas
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the foliowing from the proper FIRM (See Instructions):
1, COMMUNITY NUMBER
2. PANEL NUMBER
1 SUFFIX
4, DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
(in AO Zones, use depth)
480170
0010
E
LOMB 1/25/95
X
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): I NGVD '29 I I Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a FIFE for this building site, indicate
the community's BFE 1-_l_- l J 1 1. I 1 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 1 .
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 1141-6LsI .l 6) feet NGVD (or other FIRM datum -see Section B, Item 7).
(b). FIRM Zones V1 -V30, 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 1.1 I 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 1.1 I feet above or
below I 1 (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 1 1.1 1 feet above I 1 or below I 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 I No I I Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: I I NGVD '29 ! I 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 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: Ix I Yes I i No (See Instructions on Page 4)
5. The reference level elevation is based on: 1xI actual construction I I 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: 1 I 1416171.171 feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
I. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Itern 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: 1 1 1 1 1 1.1 1 feet NGVD (or other FIRM datum -see Section B, Item 7).
?. 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.
I certify that the information in Sections 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 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-- Suite E, Arlington_ Texas _-_ 76013
SIGNATURE DATE PHONE
4/23/97 (817)274-6883
Coj%es should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: According -to the HUD -F - lood Insurance Rate Map,-__Comm-.--Panel_No._ ..-,._-_
480170 0010E, revised to reflct 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 465.4feet, a vertical control survey
_determined the finish floor elevation of the wood forms on this lot to
be �1�8.� 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
BASE .'BASE
ADJACENT REFERENCE
FLOOD
FLOOD GRADE LEVEL
ELEVATION REFERENCE ADJACENT
ELEVATION
--
LEVEL GRADE
ADJACENr'
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.
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