FEMA-EC940322BIR - 1 12182)
The City With A Beautiful Future BUILDING PERMI T APPLICATION f E6 1 5
Building Inspecdons Division
0 Print or Type in a Clear, Legible Manner
Date: _
Job Address: LIZ 7 ej 1A
Lot: / �/ Block: Subdivision: �� % &S a"- C70rTn k>C.ed elel( Phase or Section Number:
Owner:% Address: Phone #: 1 y� 7/7 G O 2O
T fie 4 40� �. Tr�rl, �a� 7�ritTP2 i iC
Contractor: J% Address: Phone #:
z Ce4o D/=. J'o�H ,t r r= 2fY 7/7
Description of Work to be Done Class of Work: 1q Addition S Alteration ❑ Repair ❑ Demolition
�1
(' �N C''lI [>C7 -1(c OD' Si ✓r�i / /i�12>iV /7��iF'_
Area of Building in Square Feet
First Floor a 7 7 Garage 6 C Lr Value of Work �e
to be Performed �O
Second Floor � Other � Y
3 S ` GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee: Aeceipt Number
Zoning District: Occupancy Classification.
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 construction or the performance of construction.
Approved By: ; Date:
.
=
Comments:
Signature of Contractor or Authorized Agent Print Name
Fol Rec'i12t'c. 6r&r7,-xAi t?oc c,4 A'2 -Tnc .
Electrical Contractor Plumbing Contractor Mechanical Contractor
BIR - 1 12182)
D i99G =1 M.B. No 3067-0077
y1-
FEDERA MERTIIFIICAGE ,rMAR 2 3 iit�resMay 31,1993
4
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use, of this certificate does not provide a waiver of the flood insurance purchase.requirAllli31 t_This form is used only to
provide elevation information necessary to ensure compliance with. --applicable community floodplain management orclifiUftt:es, 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 FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER '
STREET ADDRESS (Includi t., Unit, uite and/or Bldg. Nk OR P.O. ROUTE AND BOX NUMBER COMPANY Ng1EtZIMQEI;, 7.
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
CITY STATE ZIP 60DE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
11.. COMMUNITY NUMBER
2. P�ANELNUMBER
3. SUFFIX
41:, DATE/OF FIRM INDEX I
5. FIRM ZONE
I 6. fiASE FLOOD ELEVATION
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ 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 I .I__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
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
oft. I M7y .2 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 ,U 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 W . U 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 I .0 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 R, 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 ❑ Nb (See Instructions on Page 4)
5. The reference level elevation is based on: 04 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 ccurse 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 _L _l L_! . L I 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 I�I JQ 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
i
u
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 elev
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 sigr
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property ownor,
owner's representative may also sign the certification.
(OV-4
•;}eference level diagrams 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway
,�Q,,''�p•� losure size, location' of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s)
ins ded in the certification under Comments below. The diagram number, Soction C,\Item 1, must still be entered.
BARRY S. af-fODE�. if
that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
�; derstand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
AL1 �c►.....e��e. '
.� r
LICENSE NUMBER (or Affix Seal)
TITLE COMPANY NAME
ADDRESS
SIGNATURE --
DATE-
_.;p?^ PHONE
n.
Copies o de of s CertlfiCate for: 1) community official, 2) insurance agent/company, and 3) building owm
COMMENTS:
ON
SLAB
A v
ZONES ZONES
WITH
BASEMENT
A
REFERENCE
ON PILES,
PIERS, OR COLUMNS
A v
ZONES ZONES
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V ZoneF
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 Ioivest horizontal structural member.
rage 2
P:EFERENCE
ELEVATION
F.E.M.A. LETTERREQUIRED.
/
MINIMUM f.f. � di
59-9* 8'-O• .
PLAN 27798L
•g.
SITE PLAN
SCALe I' • 30'-0- —
CONC.
DRIVE
LOT 18. BLOCK D. TSE VILLAGr=S
OF COTTON'NOOD C?E-=K SECT. 4
DALLAS COL -, T
COPPELL, TEXAS
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� S0d 36• CONC. WALK �
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CEN; D ON COOP
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SIDeNAL< E CQ8 / — I
G f HA AS RED'D. 87 C;TI GRANAIIA DR.
NOTE 14% MAX, SLOPE ON DRIVE °MAS VZn4
SURVEY PLAT
BARRY S. RHODES Registered Professional Land Surveyor (214) 475 - 8940
This is to certify that I have, this dsto,,qqoea careful and accurate survey on the ground of property located
at No. ¢2 7 G Q A 11,4/vl I zy� !6 , in the city of — Co PvEG c Texas
Lot No. /8 ; ilogk No. D City Block No.
of (/jLC,gGsS Of ro7'r0,,VA1od1 CPEEf' sEG'710amaddition to the City of
Texas, according to the recorded in Volumepat age
of the Map Records of pq//.vs COUNTY, TEXAS.
GRA HA M DR i vE'
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The plot hereon is true, correct, and accurate representation of the property as determined by y�� G`S ER +�
survey, the lines and dimensions of said property being as indicated by the plat: the size, location, �•q, p.,
end type of buildings and improvements are as shown, all improvements being within the boun ...,...
dories of the property, set back from property lines the distance indicated, and that the distance BARRY S. RHODES
from the nearest intersecting street, or road, is as shown on aid plot. ..........................
THERE ARE NO ENCROACHMENTS, CONFLICTS, OR PROTRUSIONS. ��cEPr s S.N�•��� �' 3691 Pv
Scala: /=azo/ THIS SURVEY WAS PERFORMED EXCLUSIVELY /o FOR ��' SVR�1��
Data: 3 - - 9¢ G E�`'/'d'✓ //0 A-, s
G.F.USE OF THIS SURVEY FOR ANY OTHER PURPOSE
, OR OTHER PARTIES SHALL BE AT THEIR RISK 1
Jao b No..:: ¢s 8 30 AND UNDERSIGNED IS NOT RESPONSIBLE TO OTHERS
Checked by:_ � ANY LOSS RESULTING THEREFROM.
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