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FEMA-EC031021T H E C I T Y O F BUILDING PERMIT APPLICATION COPPELL 5F— Print or Type in a Clear, Legible Manner wlm X A 5 9 Job Address: /j�oJnw / Date: G ^/O O y Lot: ? Block: ^ Subdivision: efewlyfR CS7ATSO Phase or Section Number: Owner: / f - aA Address: Phone #: Contractor: Address:l,aV �� Phone #: Description of Work to be Done Class of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition we%v ?Fi w o` Area of Building in Square Feet 4-30S First Floor .3A �3 Garage $P16 Value of Work to be Performed C1'Y>, cV Second Floor Other 33 4-1629, 5-Z GRAY AREA FOR OFFICE USE ONLY NOTICE This permit becomes null and void if work or construction authorized is not commenced Permit Fee: R ap $(6040 eceipt Number: t 1 ao -n Zoning District: Occupancy Classification: 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: Date: L922� 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 Comments: G %Z M2,— ,presume or local law reg ting construction or the performance of construction. A d A1 ✓� Pct Signa uorized Agen Print Name OVAL Electrical Contractor Plumbing Co tractor Mechanical Contractor eb'3 BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK ? 0 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the instructions on Daces I.7. O.M.B. No. 3067-0077 Expires December 31, 2005 SECTION A - PROPERTY OWNER INFORMATION I For Va ance Cwpeny use: I BUILDING OWNER'S NAME Policy Number John Spencer Custom Homes BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 472 Country Lane CITY STATE ZIP CODE COPPELL TX PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 3-R, BLOCK A, A REPLAT OF LOTS 3&4 OF COUNTRY ESTATES BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type): ( ##D - ##' - ##.##r°' or ##.#####D) CKNAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE COPPELL I DALLAS I TEXAS B4. MAP AND PANEL 505. 76 tt.(m) d B7. FIRM PANEL o b) Top of next higher floor B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEREVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of flooding) 4801700155 1 AUG. 23,2001 servicing the building (Describe in a Comments area) "X' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (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: ❑ Constriction DraWngs* X Building Under Construction* ❑ 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 builctng 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, ARIA, ARAE, AR/Al A30, ARIAH, 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 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? X Yes ❑ No o a) Top of bottom floor (inducting basement or enclosure) 505. 76 tt.(m) d OF T o b) Top of next higher floor — _ft.(m)G1STE�;••. o c) Bottom of lowest horizontal structural member (V zones only) ft.(m) o d) Attached garage (top of slab) o e) Lowest elevation of machinery and/or equipment J. ROWFILL w �• servicing the building (Describe in a Comments area) •RRY o f) Lowest adjacent (finished) grade (LAG) 504.. 00ft.(m) A o�Ess� o g) Highest adjacent (finished) grade (HAG) 505.00 ft(m) ••• o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade S� 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. I 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 TITLE SURVEYOR COMPANY NAME HARRYROWELL COMPANY ADDRESS CITY STATE ZIP CODE 1301 ELM STREET 201 CARROLLTON TX 75006 SIGNATOF DATE TELEPHONE (972) 242-5679 FEMA Form 81-31, Jan ary 2003 See reverse side for continuation. Replaces all previous editions C (f) C-3 LLJ W 0 C/J t06Z -4- 06 S 01 °02'00" E S 01002'00" E 9 5.5 1 ' 28.05' 10, U.E. 2011 AAi,u N 01 `02'00" W 57.57' OT 3—R N 01 "02'00" W 25.93' COUNTRY CAR R 4-LAtL's ARE REVIEWED FOR APPROVAL OF SINGLE FAINNL Y RESIDENCE ONLY. _ OIIEf2 DEP 4ICTIOTMNS OR CA.LLZUTS OWN PLOT PLAN � HAVE P LQT BEEN REVIEWED AND ARE NOT APPROVED. Z WO CITY OF COPPaL /,IEEVIEWED �3 D!1 Approval of the plana and speeftations Ad twt be construed to mean construction in direct with om City of coppell Building codes and ZonMg Ordinances. - 600 PARKER SQUARE STE. #205 I builder FLOWER MOUND, TEXAS 75028 Nk OFFICE: (972) 410-7474 subdi". COUNTRY ESTATES FAX: (972) 899-6116 blk lot3-R phase TRADEMARKED city CITY OF COPPELL SCALE: 0'-1" = 20'-0" DALLAS COUNTY, TEXAS GENERAL NOTES: DRIVEWAY 6 GARAGE: NN IZ WIDE DRIVEWAY PUBLIC SIDEWALIL MINA' HIDE date 04-10-03 Ir PRAYTOR RESIDENCE LEAD WALK TO HONE: MIN. 4' WIDE FLO SURVEY PLAT H R —R, BLOCK A, OF A REPLAT OF LOTS 33 & 4, BLOCK A OF COUNTRY ESTATES, AN ADDITION TO THE CITY OF COPPELL, DALLAS COUNTY, TEXAS, REOCRDED IN VOL.97068, PC.2952. nnninnuim III( J. C. THWEAT VOL.77093, PG. 9 123.56' N 01 02' 00" W I 28.05' o I ` k I co I cll� I CO I � I I I � I C / CY) / M CQ 1z. �' i 0 LOT 3-R / BLK. A W m / A� LOT 4—R FORMBOARD // o F.F.ELEV.505.76 M 10.0' l O / 28 0, 30' BLDG.LINE / o / o / M / -------------------- ---L--------- 10' T.-U.E. & G.T.E. ESM'T / / 25.93' 83.50' 472 COUNTRY LANE I hereby certify that on the y of�f�al this survey was made on the ground and this survey plat has been prepared as per the field notes thereby produced. and it properly represents the facts as found an the ground This survey plat has been prepared in accordance with, and in substantial compliance with , all rules and regulations promulgated by the Texas Board of Professional Land Surveying. Unless otherwise noted, the surveyor has relied solely on the record data provided in the title commitment for the determination of the boundaries of the land parcel surveyed and for any easements of record which may be shown or addressed on the survey. The survey shows viable easements, encroachments, conflicts, or protrusions apparent on the ground Date : OCTOBER 3, 2003 �P�$Go $'�;CJOB # .. 03 — 3388 GF No. E OF HARRY J. RO 4597 HA R R Y �ISrcq ••• ,, LEGEND e Scale: 1 " - z�:�� �., ��• � 9� 1/2" Steel / Iron Rod Found O ............. •••• •• 1/2" Steel / Iron Rod Set HARRY J. RO L R 0 WELL ••••............... & Associates, INC. Property Line B Food Fence — - — - - �. A 4597 Surveying &Engineering p © 2002 All Rights Reserved Chain Link / hire Fence X—X—X—X—X �.9 •••�FfSSiO • 1301 Elm Street Ste. 201 Overhead Electric EE—E— ••� Carrollton, Texas 75006