FEMA-EC981010 (3)® � IM a l 9 (P )-- 3 W q1/
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7Theutilul Future BUILDING PERMIT APPLICATION 08-21-98PO4:28 RCVD
r pj, Print or Type in a Clear, Legible Manner
Job Address: % v n .�% Date:
Lot: Lf Block: Subdivision: F'4 k,(v t,eu')Phase or Section Number:
Ownerf1(5� CC Address:hbw
AGI t k Wi �(fV� 3164
Contractor: Address: Phone #:
Description of Work to be Done Class of Work: -94
'1Vew ❑Addition ❑Alteration ❑Repair ❑Demolition
Area of Building in Square Feet �% a
First Floor V3 Garage ( V' O Value of Work /�j��•
�f to be Performed (JC/!J
Second Floor Other /
GRAY AREA FOR OFFICE USE ONLY
NOTICE permit Fee: Recent Number: � y
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 Zonirig Distridt; pp I I t occupancy Classification,
at any time after work is commenced.
Appiet mate: t
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 r'monts"
give authority to violate orgelthe provisions of any other federal, state or local law
regular gconstruction of theormance of construction.
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_Qldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, et
tom- 41 ft�>vzz. og_ A , f,\� t><t2.t�trEw-)
CITY 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
(in AO Zones, use depth)
1
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE NGVD29 ❑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 .❑ 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 - A_ .
2(a). FIRMZones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of l I 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 L 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 LLJ . ❑ 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? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevationsNGVD '29 El 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 7), then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.) 1
4. Elevation reference mark used appears on FIRM: L/ Yes U No (See Instructions on Mage 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 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 . Ll feet NGVD (or other FIRM datum—see Section B, Item 7).
?. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
' J
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
j •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 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 8 and C on this certificate represents my best efforts to interpret the data available.
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)
TITLE COMPANY NAME
Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON WIT Ii ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A v
ZONES ZONES ZONES ZONES
. REFERENCE
REFERENCE BASE LEVEL
REFERENCE
LEVEL FLOOD
LEVEL
ELEVATION
LONES
w
BASE
::�. ADJACENT•REERE
FLOOD
FLOODBASE"
GMDEREFERENCE
ELEVATION
ELEVATION ADJACENTLEVEL
GRADE
ox
ADJACENT::
� � ,.:•.:. ,,r1
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
'1'0 ALL PARTIES INTERESTED IN PREMISES SURVEYED:
1. L..lCj�f� � �:�i� - \ R k er sinnal l and Sun'eyor, do hereby cer if that a careful <urvey waw made of the prnnnd thio dair under mN .iiper%ki rn of the full Ind de rihed pwrt11%.
L.�r Vii, l��- - �1�1� wL.S5.4 �7 �t o C.Q�O,A�1.�� 4%. _._.
7 A) t om . Tax---
__ _ and there art - encroachments uprm the adjoining property or the adjuining improvements upon the described property known of
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1432 QV -A r%V1ME CZE -EK. t7izl
S'T'ATE OF TEXAS
COUNTY OFTARRANT
To,the Lienholders and/or the Owners of the Premises surveyed and to
The undersigned does hereby certify that this survey was this day made
on the ground of the property legally described hereon and is correct, and that
there are no discrepancies, conflicts, shnrtnges in area, boundary line conflicts,
encroachments, overlapping of improvements, visible lines or roads in place,
excret m shnwn hrreon, and that said property has access to apd from a
dedicaled roadway except as shown hereon."
Dated:
IIASIS I'OR nFARING:
Order No. ___----_-- ----_--
NOT FOR CONSTRUC11ON
e
QW
!0A 0 A76
FLOOD NOTE: I hereby certify that the property described herein
within a special Ilnod hazard Area as identified by the
Federal Insurance Administration, Department of Housing and Urban
Development, the flood hazard area being identified As .
of the Federal Insurance Administration Flood llazard
boundary Map effective on '
for lite — ---
-,AP SWIVEY1NG CO.
David Pollard nPS 111518
1903 Central Drive, Suite 309
Bedford, TX 76021 Metro (817) 267-1249
r1M
IN
10
CITY OF COPD L
hir bx
ZED
{ DATE
Ap,provni Of t!;c plans and specifications shall
f3p cin'� ruPd to mean construction in direct coi
with the Clay of Coppell Building codes and Zo
FORM BOARD Ordinances.
SURVEY REQUIRED
RE.M[.A. LETTEIr Irl -O nIED.
MINAMUM Ef.
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"!5.005'
1432 GRAPEVINE GREEK
Inhovative New Ideas
For Traditional Home Design
Between7The L
Residential Designers and Planners
Arlington, Texas Metro 817-2631-4121 FAX 817-274-4717
Builder/Owner to verify and check all aspects of this site and plot plan prior to
PLANS ARE RE"VIEWFD FO]
APPROVAL Ogl SItiC.LL
Ftg�hlILY iirrOf Z
�►1da.�
CAS I.-=t,-a'c --,v, j'LtiS
NOT
REVIEWEI
? APPROVED.
PLOT PLAN
in a 20,
LOT 4 BLOCK A
RIVERVIEW EST.
COPPELL, TX
FIRST TEXAS HOMES
BRI —44-,& (F8280)
COLE 6/25/98
construction —�
-V.