FEMA-EC970520�7They With ABeautiful Future B U I L D I N PERMIT APPLICATION ve 1997
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Print or Type in a Clear, Legible Manner
OPT
Job Address: (jk4 Z O y���
Date: Z �l �
Lot: Block: Subdivision: Phase or Section Number:
Owner Address:Phone #:
lzY� fir_<<<.� 5f'r J" i � -zsu �9 3 �"� I �F� 3 r_3
Contractor: t Address: Phone #: ( f
Description of Work to be Done Class of Work: [9 ew ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
r
Area of Building in Square Feet
First Floor 'E Y
Second Floor l k 3 1
NOTICE
Garage
Othery
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 constructionof the performance of construction. /
—7A-1- et�J4-� Mcar k 1--)
Signature of Contractor or Authorized Agent Print Name
L
Electrical C actor Plumtying Cgat iictor Mechan' al Contractor
Value of Work 4_
to be Performed ; 5 0, UctU
GRAY AREA FOR OFFICE USE ONLY
FPMC - 1 (4/94) S-4—red—
BUILDING
——rd—BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
0
ELEVATION CERTIFICATE Expires MO.M.B. M y31, 1077
May 31, 1993
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 I FOH INSURANCE COMPANY USE I
BUILDIN,G OWNER'S NAME I POLICY NUMBER
ADDRESS (InclAing Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER j COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Num rs, etc.)
CITY STATE ZIP CODE
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
DATE OF FIRM IND
5. FIRM ZONE
6. BASE FLOOD ELEVATION
AO Zones,
(in use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ 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 I I I.❑ 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 / .
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 141& 7. k 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 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 . ❑ 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 ❑ . 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 ❑ 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: �Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: 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: 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: I I I I I .LJ' 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 90 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),Vl—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.
l certify that the information in Sections 8 and C on this certificate represents interpret the data available.
I understand that any false statement may be punishable by fine or impriso a �, Code, Section 1001.
CERTIFI 5 NAME • aSt~ or,Affix S►1
TITLE COMPANY NAM Ci
ADDRESS CITY E STATE ZIP
SIGNATURE
Copies should be mad f this Certificate or: 1) community official, 2) insurance agenticompany, and 3) building owner.
COMMENTS: -- - --
BASE LEVEL
FLOOD
ON PILES
PIERS, OR COLUMNS
A V
ZONES ZONES
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
FLOOD
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10'x 10' 85.67
TU ELEC. ESM'T
442 COPPERSTONE TRAIL
I hereby certify that on the -o � day of f9-9-7, this survey was made on the ground as per the field notes shown on thio aunray
and is true, cornet, and accurate as to the dimensions of the subject property and sire, location and type of buildings and improvements thereon,
t if any. The survey shows all easements and visible easements of which I have knowledge or have been advised affecting the subject property.
There are no enerosehments, conflicts, or protrusions visible on the ground other than those shown.
Date MAY 20, 1997 5.
JOD #
HARRY J. R0IIELL
GF No. 4697....r�.
(D LEGEND 0
1/2" Steel / Iron Rod Found 0
f/2" Steel / Iron Rod Set
Property Line
food Fence — • — -- —
Chain Link / Wire Fence x—x—x—x—x
Overhead Electric — E — F, — E —
Scale: V'= = 20.0' 4sslo�';
�SUR�
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HARRY
R 0 WELL
& Associates, INC.
Surveying & B•ngineeri
1301 Elm Street Ste. 201
Carrolton, Texas 75006
ARC TABLE
ARC LEN._ RAL , CHRD. BRIG.
A I ' 0.38' 325.00'
'A2' 85.67' 850.00'
FC 465.20
SCALE: 1 = 20' FG 457.00
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APPROVAL OF SING`~ f F4,,M.A. LETT ZREQ ZED.
FAMILY RESIDENCE ONLY. ;;N' TL�'Ium fs.
OTHER DEPICTIONS
E-OUTS
EEEDAVQ BEN RIVV442 COPPERSTONE TRAIL
4ND AREjM APPROVED.
FORM BOARD
X00 0! CLIr'G: 461.4{7 q��R���' �.�'
Lot Area: 120715 Sq.Ft Tyke 'C' Dro+noge Fence�eng 276'
rENer LENGTH SHOWN 15 MAX,
FIELD VERIFY EXISTING rENCES
DRIVEwAV1AfUCS901WSQPPE-LL
Nt?IEi; E I mktd. cls
ENTRY
PARKWACOPPERSTONE
-- - - ,
(• UNLE9S D SUbdiv
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DATE
A proval of the plans and specifications shall not--
bi construed to mean construction in direct conflict ` 442 C o p p e rS to n e Trail
h the City of Coppell Building codes and Zoning
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Hu�IVITE
COPPELL, TX
16610 DALLAS PARY.0 I CIOtG �� plan
DALLAS. TUAS 70246
c21.,=,3-6�6• �03/14/97 , 3719.00 ELEV A RIGHT
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