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FEMA-EC960508(A) r=WZW wm$ ��Ym - , 7They With A Beautiful Future BUILDING PERMIT APPLICATION Z9Print or Type in a Clear, Legible Manner Job Address: Date: Lot: Block: Subdivision: ` \� Phase or Section Number: Owner�dress: Phone #: Contractor: — Address. �� � ��� Phone #: Description of Work to be Done Class of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition Area of Building in Square Feet First Floor � Garage ' Value of Work _�z ' C C� to be Performed Second Floor Other FPMC - 1 (4/94) � ►�> > ii1 1..1- or RE� � pA"CE �S COn .30'VERIFYTARY wER LOCAT ONIN FES OMEN of t is �►OQ�0�8�F�FIY GRADING �+• L� COMMOM bt0i GHQ IN FIELD. �:: t1 Uj�lf.f• AREA 449.9 e O�dirap�Es 103.2A �. COMMOM PLA S ARE REVI WED FOR AREA A PROVAL OF SINGLE A j FAM ;�Y R IDE CE ONLY. 1� 6' FENCE ER PIC ONS OR 449.1 w CAL OUT ON P OT PLAN HAVtNOT EEN VIEWEI HOUSE: 2025 AND ARE PROVED. FLATwORK: 1239 LOT. 11164 COVERAGE: 29.27 12'x12' PATIO t01 37' 5" 3' ADDED CO r'> 49'—Cr r\ TYPE c0h DRAIN t N 49 A 10, FORM B(J SURVEY REQUMED 1 ti ti 1 4sa., .29.7,;, 10, U,� � 4* 4 T20' Q B.L. i TC 450.72 4' 5, 39 450.9 GIBBS �, TC 450.70 • ���� ) /�c" DQi THE TOP OF SLAB MUST BE SET A MINIMUM OF 2-2x6'S ADDED 3' TO REAR 03-05-96 BF ABOVE THE HIGHEST GRADE ELEVATION OF THE BUILDING PAD. date: 2-21-96 "I do hereby certify that this droving David 'Weekle domes project: 019 or pion o d related specifications V] Bal cod requirements and 1700 feet opY Blvd., SJNTaxos 77016 (75J3067-0500 1 meet al, ;pa: 013 ore in su slonlial onformity With V.A. g65 G189S CROSSING Minima Y R ulrements. address: FLATWORK subdiv: GIBBS STATION plan: N 49 A FENCE Ik: A sect: 2 Sca1e:1" =20' 500 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 FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIL NUMBER I 'Xc5 G119Dbs CaOSStOG OTHER DESCRIPTION (Lot and Block Numbers, etc.) Lor Pt-kNSE T"C) CITY STATE ZIP CODE CoPPEUI, TE Xt�S 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 AO Zones use ELEVATION 4`�ori o 0010 &m. 1r--, \cn4 I AE, x 44-1 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): NGVD '29 L_ Other (descrlDe on DaCK) 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 I . U 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 1 I 14 IS! 2 ,lol feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 430, 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 L1 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 i ! .IJ feet above ❑ or below i- (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? n 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 8, Item 7], 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: ❑ Yes 9'No (See Instructions on Page 4) 5. The reference level elevation is based on: EXI 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: 14:1,11 .!J .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 . L.1 feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement ct ecc oCVFpCF ,Ir)r Fm 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. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Secs CERTIFIEn'SNAME LICENSE NUMBER (or Affix,Seal)! • GLE1.1N W. M1 R PENN W. MILLER TITLE COMPANY NAME.r o2 (350 UTA S�R� Y1tJG C. � �042230��:0� ADDRESS 1510 GINp DtL1�lE CITY G N NyMesUR 21P SIGNATunE DATE PHONE ma 5 -08 -fro 8n-2G\-I9-tg Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner. COMMENTS: SWC" MAtLM—s (OVAI-90 FROtA C -o05 -XT u(,V^3 Fp2 G1V%s qt ,T-koN PHpss "PLC T 10 C.iz0TlFQ OF Q.ECEs5st) Oi'l so UT I? OF Pht2 .Wb.`( 5 0 ro5c) 1 WEST 6F GB 0T1FS- Of- ►►.n 2-SEc.T t o►J OF N1q! MTH l I R Xor> FARVjo f P,Ly p EL.Ey a 45k . 31 1 11 XC k)T IN GEt rc>rtZL.W� 1t tZ,SEt-T\ON ©C� M� aR.THUR Qt�� PpRK.WAY P�Wp• ELEV• = 453,z`l,3 ON WRH ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A V A A v ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE , LEVEL REFERENCE LEVEL FLAOOD LEVEL ELEVATION k. BASE. BASE FLOOD }.'?d}: REFERENCE FLOOD ELEVATION REFEF—EN-71 ADJACENT GRADE ELEVATION LEVEL GRADE i. Tia• ... ... :ri!ADJACENT {. r1ii:::l m a:i'..f:}'.•:: �:: .; :^:p:,�..(L 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