FEMA-EC010724® Ccs m -.7—
The City With ABeautlfulFuWre BUILDING PERMIT APPLICATION
097
/7//.57 Print or Type in a Clear, Legible Manner
Job Address: - ► ,G DC-IFOR.E.5jfr Date: -if 10to I
Lot: G Block: Subdivision: I ��E�T� Phase or Section Number:
I4�E HAc,SE-Y o0
Owner (�, cs Address: Sri Phone #: q� d _ 0'�Il2. I / 70
Contractor: �h O (� I Address: L10(3 � S�' loo Phone #: 7a- ���a (770
Description of Work to be Done Class of Work: XNew ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floor 3 ( Garage Value of Work -46
to be Performed-
Second
erformed Second Floor Other
S �{ GRAY AREA FOR OFFICE USE ONLY
/fir
NOTICE Permit Fee:' I 1 -- Receipt Number:
This permit becomes null and void if work or construction authorized is not commenced Zoning District: Occupancy Classification:
within 180 days, or construction on work is suspended or abandoned for a period of 180 days It
at any time after work is commenced.
ApprZ&L'14'n
oved 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 C+t?rfinleCttS:
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.
gnature of Contractor or Authorized Agent Print Name
�+1'� EIe,C�t'iC . SAF-�-���P� ��� r►.i1'ome�E�
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
1-61
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK 8
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Read the instructions on Daaes 1 - 7.
O.M.13. No. 3067-0077'
Expires July 31, 2002
SECTION A - PROPERTY OWNER INFORMATION ( For Insurance Company Use: I
ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
Number
CITY STATE ZIP CODE
CA`PPLt_t_ TeX^S 350 101
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.)
'RES 1-I:> T/ --k1_...
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_1 GPS (Type):
( ##° - ##' - ##.##" or ##.#q###°) 1_1 NAD 1927 L_I NAD 1983 1_1 USGS Quad Map I—I Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
I B1. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER I B2. COUNTY NAME I B3. STATE
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
DATE
EFFECTIVE/REVISED DATE
ZONES)
(Zone AO, use depth of flooding)
4.$O t'10 0010
E
AWA L- IS t43°Xj-
P_I (020314-
E
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
IJ FIS Profile IJ FIRM 'Community Determined I_I Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: �VGVD 1929 IJ NAVD 1988 LJ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1Yes b4f4o
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: LJConstruction Drawings" uilding Under Construction" (JFinished 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 building 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 430, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3a-i 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 1 "W the elevation reference mark used appear on the FIRM? LJ Yes P§J►Vo
❑ a) Top of bottom floor (including basement or enclosure) ft.(M)
❑ b Top of next higher floor NA, -.-ft.(m) "•,
fe i''1... aa•'� :.
❑ c) Bottom of lowest horizontal structural member N zones only) Q- _ ft.(m) i; o At' : • t3T� • •
❑ d) Attached garage (top of slab) �� L_ ft.(m) w; G
❑ e) Lowest elevation of machinery and/or equipment
servicing the building aP'l' ft.(m)
AR Y RHO ESE 1i
❑ f) Lowest adjacent grade (LAG) 57 .5 ft.(m) 2.5m •••; ••• ••• ••
❑ g) Highest adjacent grade (HAG) ft.(m) r �-V9:10
ofl
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade iJ
❑ i) Total area of all permanent openings (flood vents) in C3h Nf A— sq. in. (sq. cm) J '••••
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.
ADS[ R�EOyO�� IV / Gt CITY STAT ZIP CODE
e.
SIGNATU D T —D TELEPHONE
FEMA Form - , AU SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
IMPORTANT:, In theswspaceid, copy the corresponding information from Section A. For Insurance Company Use:
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number
CITY STATE ZIP CODE Company NAIC Number
CAT_- 5 -.S O
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
COMMENTS
1-1 Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting
information for a LOMA or LOMR-F, Section C must be completed.
E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed –
see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is 1-1-1 ft.(m) 1_L_lin.(cm) L_I above or 1-1 below
(check one) the highest adjacent grade.
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is
I—I-1 ft.(m) I_Uin.(cm) above the highest adjacent grade.
E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance? I_I Yes I_I No 1_1 Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owners authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or
community -issued BFE) or Zone AO must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
1-1 Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below.
G1. 1_1 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2. I_I A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or
Zone AO.
G3. 1_1 The following information (Items G4 -G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
ISSUED
G7. This permit has been issued for: LI New Construction 1—I Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: _ ft.(m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
Check here if attachments
FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS
A\
p
[ SURVEY .PLAT
BARRY S. RHODES Registered Professional Land Surveyor (972) 475-8940
This is to certify that I have, this date, made a careful and accurate survey on the ground of property
located at No. 926 DEFOREST ROAD , in the city of COPPELL Texas.
Lot No. 6 _, Block No. B City Block No.
of WINDSOR ESTATES ADDITION , an addition to the City of
COPPELL, DALLAS COUNTY Texas according to the PLAT RECORDED
in VOLUME 2001077 at PAGE 02283 of the MAP ecords of DALLAS COUNTY, TEXAS.
THIS CERTIFICATION DOES NOT
TAKE INTO CONSIDERATION
ADDITIONAL FACTS THAT AND
ACCURATE TITLE SEARCH AND OR
EXAMINATION MIGHT DISCLOSE.
1/2 IRF
457.52
>2 a.
M �" u7
Y
Of
O
3
0
Z
0
Z
_Q
W
J
1- 1
2
N 39' 18'45" E 110.99,
ZIRF
458.48
ir1
NN
458.00 1,6
25.2'
459.17 ^
19.0' O
O
ca O
N N
m
ri
N
458.08
5.0' 4.8'
10
O
5.0' 4.8'
00
11.9'
N
N
25.' BL 457.76 459.23
455.69
33.0'
S 39'18'45" W
DEFOREST
14.1' ri 459.20
FORMS ONLY
NO.926
T. 0. F. =459.21 '
7.8'
N
0 15.5'
Ui
N
110.99,
iv 459.24
^ 15.0'
457.52
456.64
5
10.'
U ESM'T
The plot hereon is true, correct, and accurate representation of the property as determined by
survey, the lines and dimensions of said property being as indicated by the plat: the size, location QF
and type of building and improvements are as shown, all improvements being within the boundaries yQ�•••�too
T ••�
of the property, set back from property lines the distance indicated. �; �G .•
OQ
THERE ARE NO ENCROACHMENTS, CONFLICTS, OR PROTRUSIONS,EXCEPT AS SHOWN. RRY S R •Oi;E
THIS SURVEY WAS PERFORMED EXCLUSIVELY FOR
Scale: 1" = 20' .v•
HOLMES BUILDERS ,�•�
Date: 07-18-2001 USE OF THIS SURVEY FOR ANY OTHER PURPOSE 'r'a'h 81•, '"�
G. F. No.: OR OTHER PARTIES SHALL BE AT THERE RISK .AND
Job no.: 70286 UNDERSIGNED IS NOT RESPONSIBLE TO OTHERS
Drawn by: R. G. FOR ANY LOSS RESULTING THEREFROM.
Date Cash— Checl� No.
O pewks �J
:&:Boo e
SIOWCIA
'k, 16
Water Ta
Sewer Tap., -
A6
Final UU11ty Ins" ort :
r
..WafeWSewetAvallMIl'
i
�
w
" i
Perk
Reins ion Fees , r
TOTAL
11P�.99'
,.3� r
zLE-1-TER
8 �OMIN
IV! 114 �S .
cr.
(—OALT IN16H
C.J.COM Offs
Ga•_
D -
SURVEY r QUMM
CITY OF
VI.
rmr�--- /
Y U d DATE -
rprowd of the plans and specifications shall not
.nstru-d to me^n cons.--Uction in direct conflict
ith the City of Coppell Building Codes and Zoni
2 DL -------------
1� O x P%Z*
MAMN SATE R4 U/ GRAY
IN,rawaL� � uu a� ou�ala
0
.c' aaw,aLK
c �srrcur 49zCo DL-�o�sT
�t.ocac a, Lot b �
wi�vasoR IES7ATG8 ADDITION
GOPPELL, DALLAS COUNTY, TEXAS
= 2m'