FEMA-EC980203t o 8ci 9 q
7Theutiful Future BUILDING PERMIT APPLICATION Nov 1 s 11397
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Job Address: 1 rn-V�a Date: p� )v 7—
Lot: Block: Subdivision: Phase or Section Number:
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Owner` C ��QneAddress.�VrVb Phone #: //l) ��_�
Contractor: Address: Phone #: `Z�
Description of Work to be Done Class of Work: 4vew ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floors Garage O Value of Work
to be Performed I lJ
Second Floor 670 Other
GRAY AREA FOR OFFICE USE ONLY
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 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 constructio of the performance of construction.
1 -71M� Ctsor
Signature of Contractor or Authorized Agent print Name
`Lb,, blew IP C- _
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
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SURVEY PLAT OF
'IY)'A1,1, PARTIES INTERESTEI) IN PREMISF,S SURVE;YEI): -
L D�l7DC vi121 A Registered Professional Land Surveyor, do hereby certify that a rareful stnvcv was made of the ground this date tinder my supersision of the following descrihed prcpern.
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and there are
encroachments upon the adjoining property or the adjoining improvements upon the described property known tls
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STATE OF TEXAS
COUNTY OF TARRANT
–To the Lienholders 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 ore no discrepancies, conflicts, shortnges in area, boundary line conflicts,
encroachments, overlapping of improvements, visible lines or roads in place,
except as shown herron, and that said property has access to and front a
dedicated roadway except as down hereon."
Daled:
BASIS FOR RFARING:
Ot(ler No. -- — --- ----- —
N07 FOR C'ONSTRUC'TION
\-V32 4198
FLOOD NOTE: I hereby certify that the property desc abed h rein
within a special flood hazard area 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 Flood Ffa7ard
Boundary Map effective on — —
for the _ ---
'fly' ---- — –— -----
AP SURVEYING CO.
David Pollard RPS N1518
1903 Central Drive, Suite 309
Bedford, TX 76021 Metro (817) 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, 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.
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE j
OWNER'S NAME
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
1...0 t 13 . r31 A. , u �>z� ut tar,�•� GST 5
POLICY NUMBER
COMPANY NAIC NUMBER
CITY ,,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)
-4e0170
C010
Is:
Awd
0 14 r--
1 4470
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFENGVD'29 El Other (describe on back)
S. 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 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 ( .
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 21 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 .❑ 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 11_ 1. ❑ 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: 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 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 FIRM: es El No (See Instructions on Page 4)
5. The reference level elevation is based on: a tual construction Elconstruction drawings
(NOTE: Use of construction drawings i my 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: IL❑ ❑ feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 51-31, 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 ease of Zones AO and A (without a FEMA or community issued SFE), 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.
/ 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.
CERTIFIER'S NAMLICENSE NUMBER (or Affix Sea[)
TITL
. COMPANY NAME
K. 710
Copies should be made of this Certificate for: 1) community official, 2) insurance agenVcompany, and 3) building owner.
COMMENTS:
WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A v A
ZONES ZONES lk ZONES
BASE
FLOOD
BASEADJACENT
FLOOD. GRADE
ELEVATION REFERENCE I ADJACENT
LEVEL 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.
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