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FEMA-EC980121The City With A Beautiful Future 7 1 BUILDING PERMIT APPLICATION �'`/ 9 -1' Print or Type in a Clear, Legible Manner CF T o CT 2 ±997 Job Address:i i W j �� � �C)f9J ' Date:caw li `\Q,V.� 6 • r Lot: Block: Subdivision: p �C 1 �, Phase or Section Number: ''K l Owner` Address: Phone #: Contractor: Address: Phone #: Description of Work to be Done Class of Work: -Iew ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition Area of Building in Square Feet Z First Floor _ Garage �" Value of Workto be Performed IS -31©0 Second Floor Other / GRAY AREA FOR OFFICE USE ONLY NOTICEIN- This permit becomes null and void if work or construction authorized is not commenced p 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 that I have read and examined this application and know the same to be true r' ,�" i 7�nsh,�yywwk�J�,,;�I���r��dw���'igfC 1;44'' � i' w^ t,iw X "ri"I ya7' wti�` h X k°•"�I i) v"4�"kY „'t„ certify i of work will beIlk, and correct. All provisions of laws and ordinances governing this type complied with whether specified herein or not. The granting of a permit does not presume to wr 1w^I WiN "w I i'!nr V; 9� "i;ri� rsp am µ y"r t '' a ::ru!G Instil ti", ;nil, r4' „"fit k i.,wl 4 kiw,Xlia^' w,iw tc 4I;„ia,;g i Ih ”, �i"% a,?'it;' iu-.. rw W"wiu� "'�;dd�vl"�JCrirk, r ,.t`°"�M ;�;�U"t"+ give authority to violate or cancel the provisions of any other federal, state or local law regulating onstruction of the ormance of construction. a - ignature of Contractor or Authorized Agent(\�► �P►rriiyn�t++Name01 Pl in Co actor Mechanical Contractor; Electrical Contractor � g �� FPMC - 1 (4/94) BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK SURVEY PLAT OF TO/J.,,A, L, L PARTIES INTERESTED h-4PREMISESSURVEYED: I, �/ 4 '^Ao A Registered Pionalo, Surveyor, do treby certify that a Meful survey was made of the round this date under my supenisinn 410 described prepcm. ar jnd there art _ encroachments otw,n the adjoining propcny or the adj.rining improvements upon the described property known as N 120 50,33" W tnl m e1 N 0 N I C> i-:— V'1 S (7) N �- Y 2Z 5 12' 50— 53" E 10(o ELM FORK STATE OF TEXAS`� COUNTY OF TARRANT "To the Licnholders and/or the Owners of the premises 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, shnringes in area, boundary line conflicts, encroachments, overlapping of improvements, visible lines or roads in place, except as shown hereon, and that said property has access to and from a dedicnied roadway except as shown hereon," Dated: BASIS FOR 131:ARING: Order No.NOT FOR CONSTRUCTION 15.4 IVE 1_. e5r 12 W N •25�� O — r t0'Utt�tTvf tsr Z MA .. 11518 Q: t 18+°D u �t��ao "s; ,�t��� FLOOD NOTE: 1 hereby certify that the property described hereirt within a special flood hazard fired as identified by the Federal Insurance Administration, Department of Housing and Urban Development, the flood hazard arca being identified as of the Federal Insurance Administration Mood Hazard floundary Map effective on for the y: ---- — — --- ---- I AP SURVEYING CO. David Pollard RPS 01518 1903 Central Drive, Suite 309 Bedford, TX 76021 Metro (817) 267.1249 A 3 N f I V— -- — O 1A1 e r A 5 12' 50— 53" E 10(o ELM FORK STATE OF TEXAS`� COUNTY OF TARRANT "To the Licnholders and/or the Owners of the premises 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, shnringes in area, boundary line conflicts, encroachments, overlapping of improvements, visible lines or roads in place, except as shown hereon, and that said property has access to and from a dedicnied roadway except as shown hereon," Dated: BASIS FOR 131:ARING: Order No.NOT FOR CONSTRUCTION 15.4 IVE 1_. e5r 12 W N •25�� O — r t0'Utt�tTvf tsr Z MA .. 11518 Q: t 18+°D u �t��ao "s; ,�t��� FLOOD NOTE: 1 hereby certify that the property described hereirt within a special flood hazard fired as identified by the Federal Insurance Administration, Department of Housing and Urban Development, the flood hazard arca being identified as of the Federal Insurance Administration Mood Hazard floundary Map effective on for the y: ---- — — --- ---- I AP SURVEYING CO. David Pollard RPS 01518 1903 Central Drive, Suite 309 Bedford, TX 76021 Metro (817) 267.1249 O.M.B. NO. 3067-0077 .ELEVATION CERTIFICATE ExpiresMay31,1996 •� 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, 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 I FOR INSURANCE COMPANY USE I NAME STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER POLICY NUMBER COMPANY NAIC NUMBER OTHER DESCRIPTION (Lot and Block Numbers, etc.) CC X. iZe,PV;A9LAa 1 141 45 r•.iTv STATE 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 (in AO Zones,use depth) � J " � � 0 1c) cot o _ ' � 4 g F_ 1 '-Y T ( -� 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE),.0`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: I I . L 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 I_ . 2(a). FIRMS � Zones 41-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of W 41. LQ 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 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 . LJ 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 LL. 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? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevationsNGVD'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 77, 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:XYes ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on:Xactual 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.) '/I'I, 6. The elevation of the lowest grade immediately adjacent to the building is: I J .1 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 comm -Unity's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I ILJ feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA F3m, 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 Ai—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. I certify that the information in Sections 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. CE`FjT�FIER'S NAME � � / ^ � � LICENSE NUMBER (or Affix Seal) �( ��A 1/ f Nl Lel /S /A /p Cc 4'.)o �ZPANIY NAME A Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ON wRH ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A v A A v ZONES ZONES ZONES ZONES ZONES REFERENCE LEVEL REFERENCE REFERENCE BASE LEVEL • LEVEL FLOOD ` ELEVATION • i.}: •:: : • BABE r:::.1'f: . BASE ..s REFERENCE •ADJACENT FLOOD FLOOD GRADE '� LEVEL ELEVATION ELEVATION REFERENCE LEVEL GRADE ?:.i5::. 'i:; �:::::i: :•.;-.:; •�}�.; 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