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FEMA-EC990825\Iff) YYN ats I Dv 10 BUILDING PERMIT APPLICATION Print or Type in a Clear, Legible Manner Job Address: Z6 12021E�T Date: I� C �� Lot: Z -215 -Block: � Subdivision: tAy-F �4 Phase or Section Number: Owner � � Address: I)qoG ��, / � I 0() Phone#: ), z' Z�'7 Z� 1-770 Contractor' -7-4E7 LL�±Ir:5 LDW-1c; 04V 5 S Phone #: I7z- -Z 47-- /770 Description of Work to be Done Class of Work: ew ElAddition ❑- Alteration El Repair ❑ Demolition V OnD I� D 1,� �1� \ I / M I L y 1EIE EAS S�4-� �4 S ffi/C� Area of Building in Square Feet First Floor Z ' , D Second Floor J NOTICE Garage 570 Other /; it n u Vii' 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 construction of the performance of construction. ,Signature of -9Ktractor or Authorized Agent Print Name 1 e Electrical Contractor Plumbing Contractor Mechanical Contractor FPMC - 1 14/941 Value of WorkZ �' L to be Performed BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK 1� ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT N iENCY Expires July 31, 1999 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 pro- vide 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). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. BUILDING OWNER'S NAME SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I POLICY NUMBER STREET ADDRESS (In dinS.npt., Unit, Suite and ocr Bldg. N mbar) OR P.O. ROUTE AND BOX NUMBER I COMPANY NAIC NUMBER I �1L G�� 0 e APnDr, OTHER DESCRIPTION (Lot nd Block Numbers, etc.) 49 77 2,5 13 CITYif0 J0/_P_ // �TE - - ZIP CODE I I SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 80> i 2. PANEL NUMBER o 3. SUFFIX 1 4. DATE OF FIRM INDEX 1.2 0� O 6. ( ELEVATION in AO Zones, use ee�a4ff 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '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: U 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 Foke s 2(a). FIRMZones Al -A30, AE, AH, and A (with BFE). The top of th from the selected diagram is at an elevation of #501 1.0 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 ,U 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 is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? V Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: V 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: V Yes ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on: Vactual 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: .UJ 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 .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, MAR 97 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. 1 certify that the information in Sections 8 and C on this certificate represents my best effort a data available. I understand that any false statement may be punishable by fine or imprisonment under �1A - 0,_ 1001. "r -M 1 IrICI'7 J (VAMC LICENSE NU EA�tiBNMfMB�dh��•""""• ( � BARRY S. RHODES TITLE�•�•••• A n nOMP�Y NAME ADDR �7 / nn CITY ��p.�- • •moi, 1 J STATE `%cZIPP S � W 1 ) 77%•L7 V� I J d t5 SIGNAT RE�� DATE PHONE Copies s uldRmak of this Certificate 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 I LEVEL ELEVATION BASE.;:•.:::.:? FLOOD ADJACENT:. REFERENCE BASE FLOOD GRADE LEVEL ELEVATION REFERENCE ADJACENT - ELEVATION LEVEL GRADE 777777777 7. ADJACENT::: GRADE 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 45-4.z 67.00' WROUGHT IRON FENCE VERIFY HT. W1 OWA� _ I EXISTING EXISTING FENCE FENCE --, 5 � PATIO 54'-0* RESIDENCE b Q b 0 ao IFORM910ARD 5'UTIL. EASMT. ET MrNIMUrvl 1pk WALK AS PER CITY lk CITY CT V 636 DEFOREST ROAD PLANS ARE REV IIWLI) 1 - APPROVAL ol' , St 'S G LE TCE ONLY - FAMILY RESIDE: EPICTIONS Orlik- Approval OTiiER D -OUTS i N PLOT PLAN be reran const, N.., CALL 0 HAVE NOT BEEN REVIEWED A coppoll widiog'Arr-ti AND ARE &U APPROVFJX Liz%. T A;j -L a -IQ — -- -- I A/C PADS 1126'-0' T GARAGE L12G SLATE PIT12N. SITE PLAN SCALE, I' - 20r -O' CONC. DRIVE i LOT 25, 15'B.L. BLOCK LAKE PARK ESTATES 13'-O' 12'. 0 �-0 .0DALLAS COUNTY F.E.M. A. LE COPPRI,TEXAS 5'UTIL. EASMT. ET MrNIMUrvl 1pk WALK AS PER CITY lk CITY CT V 636 DEFOREST ROAD PLANS ARE REV IIWLI) 1 - APPROVAL ol' , St 'S G LE TCE ONLY - FAMILY RESIDE: EPICTIONS Orlik- Approval OTiiER D -OUTS i N PLOT PLAN be reran const, N.., CALL 0 HAVE NOT BEEN REVIEWED A coppoll widiog'Arr-ti AND ARE &U APPROVFJX SURVEY PLAT BARRY S. RHODES Rc,jistered Professional Land Surveyor (972) 475-8940 This is located to certify that I at No.—_. have, chis date, made a careful and accurate survey on the ground of property Lot No. 25R 636 DEFOREST ROAD in the city Of COPPELL Texas. of , Block No. E Pity Block—No---- _ LAKE PARK ADDITION , an addition the to the City of COPPELL Texas according to in VOLUME 94049 at �DALAS 'PAGE 14 PLAT ' RECORDED COUNTY, TEXAS. MAP records of ' DALLAS of the Uj 0 _ bol Li �I O 24R m 0 W Ln Z o' LL Y_ O U 5' T.I ELEC. ESMT-,\ Z F— U Q F- V) M Q 0 Z Q W J I— S 64. 22.69 _25 E DENTON CREEK 44.74' S 74' 15'24" E s/11 'RF N 75' 38' 21 " W — 67.0' 1/2" 'RS DEFOREST The plat hereon is true, correct, and accurate representation of the property as determin survey, the lines and dimensions of said property being as indicated by the plat: the size and type of building and improvements are as shown, all improvements being within the of the property, set back from property lines the distance indicated. THERE ARE NO ENCROACHMENTS, CONFLICTS, OR PROTRUSIONS, EXCEPT AS Scale: 1 " = 30' THIS SURVEY WAS PERFORMED EXCLUSIVELY FOR Date: 8-19-99 HOLMES HOMES USE OF THIS SURVEY FOR ANY OTHER PURPOSE - G. F. No.: OR OTHER PARTIES SHALL BE AT THERE RISK AND Job no.: 64715 UNDERSIGNED IS NOT RESPONSIBLE TO OTHERS Drawn by: CM FOR ANY LOSS RESULTING THEREFROM. 0 LAKE PARK ADDITION 91170 / 2650