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FEMA-EC9803247The City With A Beautiful Future BUILDING PERMIT APPLICATION DFC171997 Print or Type in a Clear, Legible Manner Job Address: ��fY1 2(.3=}- Date: i IRWTION DEP Lot: 0 Block: Subdivision: Pult Phase or Section Number: Owner cJ Address. ` Poe #: '7, /' q o _,3 Contractor: Q� Address: Phone #: Description of Work to be Done Class of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition 1 —IS Area of Building in Square Feet First Floor Garage Value of Work ��� (J � to be Performed Second Floor �j � ` Other ( ' NOTICE 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 period of 180 days Y Pe Pe Y 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 1 w W w ^` k t �n�, p'"K''f uai w"t ;,;t;?i,,y' ,, 7�w"yli "7 w' y`"wp'; , °• ,! �;Nw give authority to violate or cancel the provisions of any other federal, state or local laws regula ' g construction of the performance of construction. Signature of Contractor or Authorized Agent Print Name " Electrical Contract r Plumbing Contractor Mechanical Contractor, f� FPMC - 1 (4/94). 1iA`' BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK SURVEY PLAT OF IO_ALL PAR -I JES IN7TRESTED IN PREMISES SURVEYED: I V/Lf[11Lt'�C.(e4�/�.__ A Registered Pr "ion:d Land SiltvTor, d0 herthy certif)' thtl a rarl'faI su"ey %as made PI lire frnand thio dale under i 407__!U GlfJ�2 (%lC c�S_ZLS__C of the f11u��v ing dett'rihed 7' `s :md there arc encroachnrenrs tip in tire adjnininp pr(,Mty or if adjnininp inrpmrrntent 4 nt�m the de.crilyd progeny lmmn a+ _ .r.2 . STA'I'F OF TEXAS COUNTY OF TARRANT To the Lienholdcrs and/or the Owners of the 1'rcntiscs surveyed and to The undersigned does. hereby certify that this survey was this day made on the ground of the property legally described hereon and is correct, and that there are no discrepancies, conflicts, shortages in area, boundary line conflicts, encroachments, overlapping of improvements, visible lines or roads in place, except ae ehnwn hereon, and that said property has aM mm a^ dt-dicated roadway except as shown hereon." Vadat: BASIS FUR BEARING: Order No. NO1' rOR CONSI"RI1C1ION -- — FLOOD NOT E: 1 hereby certify that the properly desetibcd herein Within a special Olmd hazard area as Identified by the Federal Irnsurance Administration, Department of Housing and Urban Development, the flood hazard area being identified as of the Federal Insurance Administration Fhxrd Hazard Boundary Map effective on _ for the Ily: ---- - — --- --- — Af SunVEY1NG CO. David Pollard LIPS 01518 1903 Central Drive, Suite 309 tledford, IX 7602t Metro (1317) 267-1249 O.M.B. NO. 3067-0077 ELEVATION CERTIFICATE Expires May 31, 1996 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, ;o 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. OWNER'S NAME SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY MAIC NUMBER OTHER DESCRIPTION (Lot and Block I'CsT 10. —F2i\" CITY TATE 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. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION 1 1 (in A Zo es, use depth) ZO 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ;AIGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has estabrished a BFE for this building site, indicate the community's BFE: I I I I I I . LJ 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 LL . 2(a). FIRMS 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 l 1 4A:i .YJ feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, 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 ❑❑ 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 ❑ 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 ❑—I.❑ 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? ❑ Yes No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations:GVD'29 ElOther (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevatiorks 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 FIR es ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on: actual construction ❑ construction drawings (NOTE: Use of construction drawings is ly valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for a 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: I_1 ffi?LrJ.� 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 _L] . ❑ feet NGVD (or other FIRM datum—see Section B, Item 7). ?. Date of the start of construction or substantial improvement FEMA Form 81-31, MAY 93 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 B and C on this certificate represents my best efforts to interpret the data available. f understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CE IER'S NAME LICENSE NUMBER (or Affix Seal) 9'Y/,0 ©� %'X8 Tom" I . A 60MPANY NAME /' Copies should be made 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 LEVEL + ELEVATION XM BASE , `:1 . -:... FLOOD''' "" ADJACENT::"+:? REFERENCE 'y:k'i BASE FLOOD ELEVATION GRADE LEVEL REFERENCE ADJACENT ./• ELEVATION LEVEL GRADE ADJACENT;