FEMA-EC970319C1The City With A Beautitul Future
BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Job Address: �
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Date:
l!1 � t � Y
Lot: Block: -A Subdivision:
�� Phase or Section Number:
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OwnerAddress:
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Contractor: Address:
Phone #:
Description of Work to be Done Class of Work: ❑ New ❑ Addition EYAlteration ❑ Repair ❑ Demolition
Area of Building ,in Square Feet
First Floo^rl Garage
Value of Work
to be Performed
Second Floor Other
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GRAY AREA FOR OFFICE USE ONLY
3
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 days10
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
s, 4
give authority to violate or cancel the provisions of any other federal, state or local laws
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regulati s coon of the performance of construction.-
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Signature of Contractor or Authorized Agent Print Name*
Electrical Contractor Plumbing Contractor Mechanical Contractor
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FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
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O.M.B. NO. 3
ELEVATION CERTIFICATE Expirdt May 31,1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate doet 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
BUILDING OWNER'S NAME
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
GrLt Gtrvo LID CAnoQT
FOR INSURANCE COMPANY USE
POLICY NUMBER
COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Number, etc.)
4eT 58 . tbl.oc,�G h► ,�-co�ltNeoc� Gt;kc. SF�'f'to� '�L
CITY STATE ZIP CODE
C-0 PQEI,t. TX
SECTION 8 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
t. 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): W 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 I I I .0 feet NGVD (or other FIRM datum—seb Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, Indicate the diagram n1imber 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
ofl I klb .4-1 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 LLL --.0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference'evel from the selected diagram is I 1.0 feet above ❑ or
below L_ (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 .LJ 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: IN Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: 9 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: I 1 41 AJ .feet NGVD (or other FIRM datum -see
Section B. Item 7). --
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevati%;ns 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 l i i .L feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial Improvement
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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 8FE),V1—V30,VE, and V (with SFE) 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 IS U.S. Code, Se Qi
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seat;',1
•
TITLE-.�-•� . _-t-,«..•��.R
COMPANY NAME
�'P•L O ini 1N G 4223
ADDRESS CITY 9 4q�e$(°� p' ZIP
o. Pox r. Kn I N u� o
SIGNATUR
Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, And 3) building owner.
COMMENTS:
ON WIT" ON PILES,
SLAB BASEMENT VIERS, OR COLUMN)
A v A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE
BASE ��'
REFERENCE
LE
LEVEL
ROOD
ELEVATION
t1
`L.FIf..;: ri��',.
BASE
BASE
FLOOD ADJACENT :'.;. !j REFERENCE
FLOOD
ELEVATION REFERENCE ADJACENT GRADE ";,y LEVEL
ELEVATION
LEVEL GRADE ''C•'
::>•;' /.. :..i ;;:.'.•4::.'.;^j.:
Vii: 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
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PLAT SHOWING
LOT 58, in BLOCK A, of VILLAGE AT COTTONWOOD CREEK SECTION VI, BEING A
REPLAT OF LOTS 1,2,3, and 4, BLOCK 1, VILLAGE AT COTTONWOOD CREEK SECTION
II, an Addition to the City of Coppell, Dallas County, Texas, according
to the Map or Plat thereof recorded in Volume 9.5036, Page 1867, Map
Records, Dallas County, Texas.
Commonly known as 621 Gifford Court.
THIS PROPERTY IS LOCATED IN ZONE (S) AS DELINEATED ON FLOOD INSURANCE RATE MAP
PANEL NO. EFFECTIVE DATE LOCALIZED FLOODING
NOT DETERMINED.
P. 0. Box 13556 • Land Swveving
Arlington, Texas a Land PlwiWng
GEOOATA SURVEYING, INC. 76094-0556 ' TOpograppNc
Metro 261-2878 Mapping
LEGEND
o ....... iron rod
—x --x . — ...... fence line
— T— —E— — ...... utility line
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tiYi(ri the cit0 mean constrUctiQn in shallfi
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PORM BOARD
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F.P.- 472.1
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6' FENCE
39•-1'
6,�5 24'-0"
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UR'VEY REQUIR1�1J `o, 470.7 4' s.
28' �G �
t ) STREET CUT
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HOUSE: 3025 O)Q—)D
IDT: 16640
COVERAGE: 17.7%
THE TOP OF SLAB MUST BE LJkD I]' TC 469.6 469.8
SET A MINIMUM OF 2-2x6'S REV ADDED 4' EXT. TO MASTER 04-08-97 TOA
ABOVE THE HIGHEST GRADE REV MOVE S 428 D OVER 04-02-97 TDA
ELEVATION OF THE BUILDING PAD. ADDEO 4' TO GARAGE 03/18/97 RRO
'1 do hereby certify that this drawing date: 02-07-97
77oS6
or plan and relot d specificotion' DavI Vee le Homes
meet all local t e requirements and 1300pp Pool06k�„o &0* Io00 ►tewlen. twos (7��)9eA-O'J00 RR8 P 1
rt)'t3ct: 303
ort ins ti conformity wi V.A.
Alinlmu Prop y Require ane . address: 621 CIFFORD COURT job: 0080
Lw v 15r-, COTTONWOOD CREEK plan: S 428 0 FLATWORK
/ FENCE
lot: 58 blk: A sect: 6 scole:l =20' SOD