FEMA-EC941107--
Future
C
Job Address: /036
Lot: 2--7 Block:
Owner:
/-/ C-
- /C- in
,On
Contractor:
Description of Work to be Done
of Building in Square Feet
First Floor- 1-7q_
Second Floor -36ac-
NOTICE
BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
r
OCT 25
==� - ; r
�ec� 1 Date: / G/2S/�
Subdivision:
h e S. Address: 16(90 cam/ c
Address: —5/e— 200 6UI
Class of rk: �ew ❑Addition
/7Q, ft
Garage -33 9
Other a
Ibis 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 orA5Rxl the Wvisions of any other f stag or local law
regrl constr�or A e 7F" construction.
or or Auth 'zed Agent Print Name
Qe,4 e
Plumbing Contractor MechaniKI Contractor
FPMC -1 (4/94)
Phase or Section Number:
Phone #: 380-23666 e,>fi360
Pone #: .5GPr k-� e
❑ Alteration ❑ Repair ❑ Demolition
Value of Work
to be Performed__�L _
A FOR OFFICE USE ONLY
• ELEVATION CERTIFICATE EExpiresM y3671993
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.
BUILDING OWNER'S NAME
SECTION A PROPERTY INFORMATION I FOF, INSURANCE COMPANY USE 1 -
POLICY NUMBER
STREET ADDRESS (Including Apt. Unit, Suite and/or Bldg. Number!),QEVO. ROUTE AND BOX NUMBER COMPANY MAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.) �+ /�
ZV -7/—. Z7- T2/ /�/ i- .C— 7 " / i T?/> c _ �T1f f Y�.f� %��
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
4. ATE OF FIRM INDEX
�P,�
5. FIRM 0 E
6. BASE FLOOD ELEVATION
fn AO zones, use depth)
. /�
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): rlNGVD'29 ❑ 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: f 141 11.4 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 1 1 461 AZ 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 I I I I I I .LJ 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 W . U feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number;-, available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ 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 onFIRM' 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 I .0 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
9f111C170N s 0OMPICAtION
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 Ai—A30, AE, AH,.A (with 13FE),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, IT est 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.
l understand that any false statement may be punishable by fine or imprisonment u ode, Section 1001.
NA
�E OFT 1
NAME
ADDRESS TY `�d• cQr fig /' STATE ZIP
Copies should be(Made of this Certifib4te for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
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
ELEVATION
,nl•,
�4:�y,:;i,ti„xtR;�i <;ylY,!;k u.",'•?.`':t;�#i'..
..,: `µ}�'
:� :.•ti
BASE .A ,. •.. ;•.. ::::..,,,..: •;. .: ,rA'
FLOOD ADJACENT :1' REFERENCE
••ADJACENT
BASE
FLOOD
GRADE .•3 LEVEL
ELEVATION REFERENCE
r�
ELEVATION
LEVEL GRACE
•.,:•
r:.: •:-'r:� .;:.Y•; .:; ...:
GRADE
The diagrams above illustrate the points at which the elevations should be measured ;n 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 J
FLOODPLAIN EASEMENT
Il FORM B040D 1
1 WRVEY REQUIRED �
j .
1
iC>5� EREEK CROSS Aqc) STRM CUIr
yvi¢iI 4,
_
eq*l
CITY OF COPPELL
&4;,,nd
IEWED
;)ATE
be const .: speclfiC2�t1�r1S Shalt rd
;n*uction in direct con-
flict with ;�;, ,;�y ,, Uppell Building Codes and
Zoning Orditomm
risk
SURVE:Y�PL�AT
c
ram
W
V
V
Lor 26
4:
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rti
Oyi
63.76'
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I hereby certify that on the VA'dlo
ay of 192124— this survey was made on the ground as per the field notes shown on this survey 00
and Is true, correct, and accurate as to the dimensions of the subject property and size, 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 encroachments, conflicts, or protrusions visible on the ground other than those shown.
10
10
OF
Date /1!!'�Jl 3. t/(L' r,~Pt� `t•.k s:9s
--TJCB #
- HARRY J. ROWELL
GF No.4597
Scale:
--- -----LEGEND 0 11, rn��a�
,= Z� y ' A R R Y
11/2" Steel / Iron Rod Found - O /�
1/2" Steel / Iron Rod Set
PropertyROWELL
Ii Lint �� .,}Lfcec-��
i Dud Fence — • — . — . _ . _ ._ � f" � ,. a Associates, INC.
Chain Link / Wirt Fence X—X—k—X—X U Surveying $ Engineering
..rheod 1301 r'1 r. $treat $te. 201
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_ ._ ... Carroillon, Texas 75006