FEMA-EC960201w
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The City With A Beautiful Future BUILDING PERMIT APPLICATION C is f- 13-3
Z'-'; mV e (7Tzt'?–o-;�—Type
4 1 Z 7 Sf T /00— in a Clear, Legible Manner q A AR
Job Address: Date: / ?617c-,
Lot: Block: Subdivision: �' ,. c / L Phase or Section Number:
I �J ✓ 'T`a f r d. 1
Owner Address: + ' T/ '7 iZ-I PPhone #:
Contractor: S � Address: %UO ✓ I t P��r k Phone #: "0/
7/ 2-3c` .Y
Description of Work to be Done Class of Work: XNew ❑ Addition Alteration ❑ Repair ❑ Demolition
5�R-
Area of Building in Square Feet
First Floor f r rU Garage T U ,-'
g Value of Work
_ to be Performed _ 5
Second Floor G `l) Other I Z Z_
375-4-0 GRAY AREA FOR OFFICE USE ONLY
Signature of Contractor or Authorized Agent Print Name
empo
Electrical Contractor Plumbing Contractor Mechanical Contractor -
FPMC - 1 (4/94)
ELEVATION CERTIFICATE O.M.B. No May 31, 1993
Expires May 3 r, 1993
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 FOH INSURANCE COMPANY USE I
BUILDING OWNER'S NAME , / I POLICY NUMBER
STREET ADDRESS (Includingt., Unit, Suite and/or Idg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
Lo T 3� � ,C�G.L/. � , �%88S ST.4�/�� �t/AS� Tv✓�
CITY�Q���G� 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
`27-60l 70
(in AO Zones, use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): �GVD '29 ❑ 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 . ❑ 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 ___L_ .
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 LL_ 441Z Zl J8 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 ❑i . ❑ 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 ❑' . ❑ 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? i' es ❑ 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 i4, 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 F-1No(See Instructions on Page 4)
5. The reference level elevation is based on: [J 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: ❑ .!2 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 114417 .a feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E vLATIFICATION
This certification is to be signed by a land surveyor, encg r ter, or .rchliect who is authorized by state or local law to certify elevation
information when the elevation information for Z, .�s A A30, t,. , AH, A (with 13FE),V1-V30,VE, and V (with BFE) is required.
Community offi,.lals who are authorized by local >w or c dinanc to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (wi ,,ut a :MA of ,ommunity issued BFE), a budding official, a property owner, or an
owner's representative may also sign the c,:rtif -Jon.
Reference leve; diagrams 6, 7 and 8 - Dist', _Jshing Featu-,es he ck)rtifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equip .ie, t, area use, wall , nir_ts, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comm, Its elow. The diagram number, Section C, Item 1, must still be entered.
f certify that the information in Sections 8 an I C on this certificate represents my b cs to interpret the data available.
/ understand that any false statement may b punishable by fine or i oprison.� f iS, Code, Section 1001.
CERTIFIER'S NAME
ITLE
ADDRESS
SIGNATURE C
Copies should be mad of this Certificate for: 1) commLl:lity official, 2) insurance agent/company, and 3) building owner.
E NUMBER (or Affix Seal)
1" �l
6,
,OK)PAN1 NAM
CITY STATE ZIF'elDATE PHO�&
COMMENTS:
ON
SLAB
A
ZONES ZONES
FLOOD
ELEVATION
WITH
BASEMENT
A
ZONES
BASE
FLOOD
ADJA - REFEREN
GRAD- LEVEL
ADJACENT
PIERS, OR COLUMNS
A. V
ZONES ZONES
REFERENCE
LEVEL
BASE
FLOOD
ELEVATION
.. ADJACENT.'.
.D
GRADE '.
The diac,. rams 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 measurL;d at the bottom of the lowest horizontal structural member.
Page 2
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Lot Area: 8020 Sq.Ft.
GENERAL NOTES;
DRIVEWAYS 12' WIDE »
ENTRY WALKWAYS 3' WIDE »
PARKWAY SIDEWALKS 4' WIDE »
(. UNLESS OTHERWISE NOTED)
16610 DALLAS PARKWT�Y. SUITE 2300
DALLAS• TEXAS 75244
(214) 713-4414
TOC =450.2
Type 'C' Drainage Fence Lengthy 224'
FENCE LENGTH SHOWN 15 MAX.
FIELD VERIFY EXISTING FENCES.
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01/24/96 1_ 37.45.00 ELEV A RIGHT
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A Ili ISUIQVEY PLA Ti"
LOT 36, BLOCK E, OF CI13BS STATION, PHASE TWO, AN ADDITION
TO THE CITY OF COPPELL, DALLAS COUNTY, TEXAS.
CALL 85.83' MEAS.85.55'
1,0T 35
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eV this survey was made ctocaiionrand a ype of buas per tildinga nde field eimprovemvntahth.,is im'- v 1 J
f n w dq or hav been cdvised affecting the subject property. p
,'%xre are no ener-:achrr.m! conftirts, or protrusions i--ribte on the ground other than tho.*e shown. V
FF0 t,2 UA R AV 1996
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CF .CIo. 4597
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Scale: 1" = 20.0' � �1��wssip, H�11 1� l 1{p
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Avsociates. INV.
Surveying & Engineering I j
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1301 Ftm Street Ste. M f
BOLD HARMLESS AGREEMENT
WHEREAS, THE OWNER OF LOT—, BLOCK—6 OF
THEOb& S�. SUBDIVISION, 1,0135r /f�diS C Sjw1G (ADDRESS),
COPPELL, TEXAS (THE OWNER) UNDERSTAND AND ACKNOWLEDGE THAT THE
DECK WHICH IS LOCATED ON THEIR PROPERTY ENCROACHES ONTO THE CITY OF
COPPELL'S DRAINAGE EASEMENT; AND
WHEREAS, THE OWNERS UNDERSTAND AND ACKNOWLEDGE THAT IN CASE
REPAIRS OR IMPROVEMENTS ARE REQUIRED TO BE MADE TO THE CITY OF
COPPELL'S DRAINAGE EASEMENT WHICH WOULD REQUIRE REMOVAL OF THE
DECK IN ORDER TO EFFECT SUCH IMPROVEMENTS; AND
WHEREAS, THE OWNERS RECOGNIZE AND ACKNOWLEDGE THAT SUCH
DECK WAS INSTALLED DESPITE KNOWLEDGE OF THE CITY'S DRAINAGE
EASEMENT;
OWNERS HEREBY AGREE TO REMOVE SUCH DECK AT THEIR OWN COST
AND UPON REQUEST BY THE CITY OF COPPELL, AND IF OWNERS FAIL TO REMOVE
THE DECK UPON REQUEST BY THE CITY, THEN CITY WILL REMOVE SUCH DECK
AND OWNERS HEREBY INDEMNIFY AND HOLD THE CITY HARMLESS FROM ALL
CLAIMS OF DAMAGE TO THE DECK WHICH ARISE FROM THE CITY'S REMOVAL OF
SUCH DECK WHILE REPAIRING, INSPECTING, IMPROVING OR IN ANY WAY SEEKING
ACCESS TO THE DRAINAGE EASEMENT. ADDITIONALLY, OWNERS AGREE TO
REIMBURSE THE CITY FOR REASONABLE COSTS INCURRED IN REMOVING THE
DECK.
DATE L-N–q�
(owner)