FEMA-EC940317yk�
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he City With A Beautiful Future BUILDING PERMIT APPLICATION
Building Inspections Division
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112'3-)-1 Print or Type in a Clear, Legible Manner 1
Job Address: I O 1 �C /O55 S Date: -512( f q
Lot: -� Block: Subdivision: G s.Phase or Section Number: t
'tau`
Owner: �� Address: �. U o � � �Ic-S �k� � � � Phone #:,2 (rA - 3 t o -2 316 b
Contractor: Address:Wil i �kw� X23%;c Phone
Description of Work to be Done Class of Work: Pq New ❑Addition ❑ Alteration ❑ Repair ❑Demolition
S; � I / 2
Area of Building in Square Feet
First Floor -2
Second Floor Ss
Garage �-9 5'
Other � � 3
Value of Work
to be Performed Z Z t 100
8 S GRAY AREA FOR OFFICE USE ONLY
NOTICE permit Tee:" fiieceipt Number:12,71
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 Zoning District:
Occupancy Classification:
days 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
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 Comments
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction or the performance of construction.
Llt(5v O� �PtM Cit L!
Signature of Contractor br Authorized Agent Print Name
R 1Z TE PC
Electrical Contractor Plumbing Contractor Mechanical Contractor
BIR - 1 12/621
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SITE PLAN
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LOT 17 BLOCK E
GIBBS STATION
PHASE II
COPPELL. TEXAS
1
ELEVATION CERTIFICATE Q.M.&NO3067-0077
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 LOMR).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNERS
111J.�.Z��
STREET ADDRESS (Ir►ckldirlg Apt., Unita and/or Bldg Number) S"O. ROUTE AND BOX NUMBER
OTHE DESCRIPTION (Lot and Block Numbers, etc.)
CITY
FOh INSURANCE COMPANY USE
POLICY NUMBER --
COMPANY NAIL NUMBER
STATE ZIP CODE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
t. COMMUNITY NUMBER
I %�
2. PANEL NUMBER
�AD
3. SUFFIX
G
4..,P�AT,E OF FIRM ,INDM
T�. 1S
5. FIRM ZONE
1>e-,
6. BASE FLOOD ELEVATION
(in AO Zorws6 use depth)
I. Imticale the elevation datum system used on the FIRM for Base Flood Elevations (BFE): �IGVD'29 ❑ Other (describe on back)
S. 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,LJ feet NGVD (or other FIRM datum -we Section S. 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 14 1831,12 feet NGVD (or other FIRM datum -see Section B, Item 7).
(b). FIRM Zones V1 430, 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 IJ 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 W . U 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 LJ -J . L feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the g's lowest floor (reference
level) elevated in accordance with.the communitys.tloodplain,ntanagement ordirkvx6?,Y-es ❑—No E] Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: E NGVD'29 ❑ Other (describe
under Comments on Page 2). (NOTE.• lithe elevation datum used in measuring the elevations is different than that used on
the FIRM [see Section B, Item 71, 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:
��Bles ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: L✓�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 Cergfkete
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).
CERT IFIEWS NAME LICENSE NUMBER (or Atfuk Seal)
TITLE COMPANY NAME - -
ADD Els l /yQ�r Me mosso .,Z�oc
CITY STATE ZIP
Z -A . 'r _ C�rt��o4 . Tr. 7500
SIGNATURE DATE PHONE
014 Z97 - 5G 79
O
HR SURVEY PLAT
LOT 17, BLOCK E, OF CIBBS STATION PHASE TWO, AN ADDITION
TO THE CITY OF COPPELL, DALLAS COUNTY, TEXAS.
LOT 16
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33.63' w
100 YBAR�D PLAIN_ `—
HIGH BANK
LOT 17
BLK. E
8.0'
8.0'
25' BUILDING LINE
8.0'
h 1
N
-------------
10' UTILITY ESM'T
90 00'30" -----------------
,k t 5' TU ESM'T
S 79 12' 37" W
REFERENCE BEARING
41.45' 27.49'
LOT 18
1016 CREEK CROSSING
HR
I hereby vertify that on ths-&!!day of AJAZ 19-94 this survey was made on the ground as per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and rise, location and type of buildings and improvements thereon,
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 eneroaohmsnts, conflicts, or protrusions visible on the ground other than those shown
sF 0
er�fi
Date A1,4R�f-N /7, JOB # .
:.
fIARRY J. R......
GF No. 4597 .
0 LEGEND 0
1/2" Steel / Iron Rod Found 0
112" Steel / Iron Rod Set
Property Line
Food Fence — • — • — • — —
Chain Link / Fire Fence x—x—x—x—x
OvorMad Electric—E--E---F-.-
y c •�
Scale: I"
HARRY
R 0 WELL
k Associates, INC.
Surveying k Engineering
1301 Elm Street Ste. 201
Carrollton, Texas 75006
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BOARD
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ELEV. 453.68
c1'
8.0'
25' BUILDING LINE
8.0'
h 1
N
-------------
10' UTILITY ESM'T
90 00'30" -----------------
,k t 5' TU ESM'T
S 79 12' 37" W
REFERENCE BEARING
41.45' 27.49'
LOT 18
1016 CREEK CROSSING
HR
I hereby vertify that on ths-&!!day of AJAZ 19-94 this survey was made on the ground as per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and rise, location and type of buildings and improvements thereon,
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 eneroaohmsnts, conflicts, or protrusions visible on the ground other than those shown
sF 0
er�fi
Date A1,4R�f-N /7, JOB # .
:.
fIARRY J. R......
GF No. 4597 .
0 LEGEND 0
1/2" Steel / Iron Rod Found 0
112" Steel / Iron Rod Set
Property Line
Food Fence — • — • — • — —
Chain Link / Fire Fence x—x—x—x—x
OvorMad Electric—E--E---F-.-
y c •�
Scale: I"
HARRY
R 0 WELL
k Associates, INC.
Surveying k Engineering
1301 Elm Street Ste. 201
Carrollton, Texas 75006