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FEMA-EC980121 (9)Area of Building in Square Feet First Floor Garage 7 Value of Work to be Performed 0� I D C; Second Floor � � Other d, / 2 a g GRAY AREA FOR OFFICE USE ONLY 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 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 constructierrePitm performance of construction. CL ry'C KC str r Signature of Contra or or tt orized Agent ; rint Name Electrical Contractor Plumbing Contractor Mechanical Contractor FPMC - 1 (4/94) BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK 7Thety With A Beautiful Future BUILDING PERMIT APPLICATION Print Type in a Clear, Legible Manner/L(4-�J�� G � 6 01997 or Job Address: Date: ld�Z Lot: Block: Subdivision: �� v t Phase or Section Number: Owner �,` e Address• Phone #: - 7 7 �J i Contractor:�m Address: Phone #: Description of Work to be Done ;�a1 Class of Work: —Q -Kew ❑ Addition ❑ Alteration I ❑Repair F1 Demolition Area of Building in Square Feet First Floor Garage 7 Value of Work to be Performed 0� I D C; Second Floor � � Other d, / 2 a g GRAY AREA FOR OFFICE USE ONLY 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 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 constructierrePitm performance of construction. CL ry'C KC str r Signature of Contra or or tt orized Agent ; rint Name Electrical Contractor Plumbing Contractor Mechanical Contractor FPMC - 1 (4/94) BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK 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 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 F j2,sr 7;i- AS Worn1Er1 STREET ADDRESS (Including Apt., Unit, S4ite and/or Bldg. qurnber) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER OTHER DESCRIPTION (Lgiand Block CITY IF TE ZIP CODE Co P �1 XAas 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) t� Coto 1 A 40= 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 .❑ 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 I_ . 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 ❑6 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 .❑ 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 W . ❑ 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 FIR&4 (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.) y 4. Elevation reference mark used appears on FIRM:/Yes ❑ 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: feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY 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 managemgnt ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I I . ❑ 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 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR 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 Ai—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 S - 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. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) CAVA 0 kao I's -1 8 TITI F .. COMPANY NAME _ 94L CITY ZIP ADDIESfJ 7S/c.►ZJ7 ��1�CrlY�Gl/ STATE ;r no SIGNATLIPE Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: i ON WITH ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A V A A V ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE BASE LEVEL REFERENCE LEVEL LEVEL FLOOD ` ELEVATION A ,!,?.'`i;{'.Tit: •.:: i:i?' :'.mit: ; BASE "_ .ADJACENT.::',•: ;! RE FLOOD FLAOOD GRADE LEVELCE1 ELEVATIEVATI ON ELEVATION REFERENCE AWACENT + LEVEL GRADE •::,; :i::i:i•::::•:%`;?.ii::::"t`: •. .:'.;:!•i:;:., ::::%'ADJACENT}. ..:i 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 SURVEY PLAT OF O AL.L PARTIES INTERESTED IN PREMISES SURVEYED: [IASIS 17OR BLARING: Order No, Nor POR coNSTRt1CT10N AP SURVEYING CO. David Pollard RPS N1518 1903 Central Drive, Suite 309 Bedford, rX 76021 Metro (817) 267.1249 D Ida/ 12L DATE FA ARE REVIEWED FOR nroval of the o _3nd speci�atians shall nr APPROVAL OF SINGLE construed fc mean cogstruftn in direct connMILY RESIDENCE ONLY. th the Cir`, If r3oppek3uildinr ,odea and or,THER i,�FPICTIONS ORLL,-OUTS PLOT PLAN AVE, NOT BEEN .EV1JFWEI) AND ARE NOT A?P ROVED F.E.M A. LETTER( Mi1+IIM17�[ f f . ALLEY -011 541-6" 121-611 , 75.00' 181 WIDE OONO. DRIVE n 555.8,FF 201E J 555.SFF 554.8FP FORM BOA= 555.8FF 554.8FP , T MEM