FEMA-EC940407 (2)z*�f
TM City With ABeautiful Future BUILDING ERM T APPLICATION
Buiiding Inspections Division1-7 7 INIYi 2 j Q4
3 Print or Type in a Clear, Legible Manner �—
Job Address: -�j2Date:
Lot: Block: Subdivision: EAI L -E✓ ) (tom V 1 �.a.-�C Phase or Section Number:
Owner: 14u'M NWCT V') � Address: 1{ b -a (-otI3&,r,-4s-At�,0 W Phone #: '12)— q no �
Contractor: S N v,/\ t= A, S N Address:
Phone #:
Description of Work to be Done Class of Work: ® New Addition ❑ Alteration ❑ Repair ❑ Demolition
ea of Building in Square Feet
First Floor 29 Q
Second Floor
Garage J�
Other Z(vZ
Value of Work
to be Performed q 00 O
ti
GRAY AREA FOR OFFICE USE ONLY
NOTICE Permit Fee: �' receipt Number:
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 Zoning District. Occupancy Classification:
days at any time after work is commenced. , f
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 or the performance of construction.
Signature of Nmractor or Authorized Agent Print Name
I}0-5� -Qkle� TesAAPo
Electrical Contractor Plumbing Contractor Mechanical Contractor
SIR .1 (2192)
ELEVATION CERTIFICATE
+ � O.M.B. No 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY ExpiresMay31, r993
NATIONAL ATTENTION: Use of this certificate does not provide a waiver erof ODhe the insuranINSURANCE PROGRAM urchase 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
BUILDING p11VNER'S NAME FOh INSURANCE COMPANY USE
✓(p +COM'PANYUMBER
STREET ADDRESS (Including Apt„ U it uite and/or Bldg. Nu OR P.O. ROUTE AND BOX NUMBER
NAIL NUMBER
OTHER D SCRIPTION (Lot and Block Numbers, etc.)
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)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): QIGVD '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: L i I IJ . 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 1_
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 L. 1.14 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 LJ 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 LL -L 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? E�Y�esNo
D Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: t NGVD '2 ❑ 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 item
equation under Comments
7J, then convert the elevations to the datum system used on the FIRM and show the conversion
s on Page 2.)
4. Elevation reference mark used appears on FIR
Yes 11 No (See Instructions on Page 4)
5. The reference level elevation is based on: actual 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:
Section B, Item 7). LLAM0.7 feet NGVD (or other FIRM datum -see
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies
is not the "lowest floor" as defined in the Community's floodplain manaement ordinanreference
the elevation of theelbu Id ng'slowes�tt m 1
floor" as defined by the ordinance is: L. I I I I I (J fceeet NGVD (or other FIRM datum—see Section B, Item 7). ,
2. Date of the start of construction or substantial impr. ovement
FEMA Form 81-31, MAY 90
REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
r
$EC tldht iii �ieipfi�ie�►TICyN '' ''
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.,,S ection 1001.
of= ��iA
CERTIFIER'S NAME
LICENSE NUM ffix v'
G COMPANY NAME +� �% v':V�LI
TITLE_ — / 1/
/ Tb .J c
ADDRESS �� CITY I %el 1�^�p�$q�� rsw�y+ ATE ZIP
SIGNATOR DATE
Copies should be rade of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON WITH ON PILES,
BASEMENT PIERS, OR COLUMNS
SLAB
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL
REFERENCE
REFERENCE BASE
LEVEL
LEVEL FLOOD
ELEVATION
BASE
BASE ...'..:'.. ADJACENT: '''k'' REFERENCE
FLOOD
ELEVATION
FLOOD GRADE �:�;` LEVEL
ELEVATION REFERENCE ADJACENT i;
LEVEL GRADE �'•
•. ..'r.:; :.:.;..'r.... :.i:
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
03/16/1994 15:48, •0600000
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GfTY OP GOPPEU., TX
94-226
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SURVEY PLAT
LOT 41, BLOCK A, OF EAGLE POINT AT RIVERCHASE, AN ADDITION
TO THE CITY OF COPPELL, DALLAS COUNTY, TEXAS.
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I hereby certify that on the -_day of , 19 52,1r , this survey was made on the ground as per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and size, location and type of buildings and improvements thereon,
if any. The survey shows all easements and visile easements of which I have knowledge or have been advised affecting the subject property.
There are no encroachments, conflicts, or protrusions visible on the ground other than those shown.
Dat@ :
0 F�,
R 4: In
JOB #
HARRY J. ROW
ELL
GF No. 4597
LEGEND 0 Scale: 1 z:!s t'o/
1/2" Steel /Iron Rod Found 0
1/2" Steel / Iron Rod Set
Property Line
Wood Fence ...... — . �`7—
Chain Link / Wire Fence x—x—x—x—x
! Overhead Electric — E. --.- E---
..
HR
HARRY
ROWELL .
& Associates, INC.
Surveying & Engineering
1301 Fim Street Ste. 201
j C'a�ra!i1an, Texas ,'•�'i;r,