FEMA-EC971211FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
5-6
i
NOV 2 51997
a7They With A Beautiful Future BUILDING PERMIT APPLICATION
L
7 3, 2 q Print or Type in a Clear, Legible Manner
INSPECTION DEPT
10 * 2t4 34(c C Date: AJO ✓ember 19 1997
Job Address: 3o(, /4 E,qet hst o
yie,
Lot: 18 Block: I Subdivision: DLd WPPCLL EStAt65 Phase or Section Number:
Owner S lam. E e t CCs � m &d me5 Address: pD. pX 13 �, CoPPE a, Phone #: 1772 _3 93 20 79
Contractor: 5,gj"6- Address: Phone #:
Description of Work to be Done Class of Work: [4 New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
ter- J A) r ,L6 F'Am 1 c cl 26 LACMEt2
Area of Building in Square Feet
First Floor 19430 Garage 11097 Value of Work 00
to be Performed
Second Floor Other
GRAY AREA FOR OFFICE USE ONLY
4,11 NA
�4 �f
NOTICE s
This permit becomes null and void if work or construction authorized is not commenced.;
for 180 days
within 180 days, or construction on work is suspended or abandoned a period of
at any time after work is commenced. �d +
I hereby certify that I have read and examined this application and know the same to be true kr..
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 of the performance of construction.
Rcl ;03 ke-0
nature of Co tractor or Authorized Agent Print Name
£
Ri C Electric, `t
Electrical Contractor 'Plumbing Contractor Mechanical Contractor e r
r
{. r
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
5-6
. ELEVATION CERTIFICATE
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
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
3 0(P /7'.E' 7&,S 710AIAF L �
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
LDT /8 S44Gk / 0/-- 474Z 4=67-S,
CITY STATE ZIP CODE
Co ADZ C , 7'X
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
S. FIRM ZONE
6. BASE FLOOD ELEVATION
(in AO Zones, use depth)
��o/alb
406
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7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 U Other (describe on back)
S. For Zones A or V, where no SFE 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 .0 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
Q oil I X1014.1 A 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
0 the selected diagram, is at an elevation of I I I i l l .0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(c) -
L
FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is U.0 feet above ❑ or
below El(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 LU . U 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
0 level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
,i 3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD '29 ❑ Other (describe
q 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: ® Yes ❑ No (See Instructions on Page 4)
Q' 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: I I I I I I .0 feet NGVD (or other FIRM datum -see
Section B, Item 7).
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 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.
1 certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
1 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 Aix Seal)
TITLE COMPANY NAME
S,W4Veyo1;? fi/•9AP.t'li eow,C 1 4 -
ADDRESS
ADDRESS CITY STATE ZIP
/30/ k4M-Cr)eeE7- 0,Ve c>✓.[.r-'o ?"X. 9SO66
SIGNATURE DATE l9 22, Z
Copies should be made of this Certificate for: 11) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS:
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,' ITPVEY PLAT
BEING LOT 18 BLOCK 1 OF OLD COPPELL ESTATES AN ADDITION TO THE CITY
�! OF COPPELL, DALLAS COUNTY, TEXAS. RECORDED IN VOLUME 96020, PAGE
J 2443, P.R.D.C.T.
'.j
MARY STONE MYERS
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VOL. 7:3005, PG. 2820, D.R.D.C.T.
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CALLED 80.00 MEAS. 79.91
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LOT 18
BLK. 1
aco
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20' B. L.
HEAD WALL
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FORMBOARDS
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LOT 17
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10.0
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25' B. L.
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10' UTIL. ESMT.
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( i 80.00
.
REFERENCE RRG.
i S 4°36'23" W
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C1!
8.0
90°0'.52"
LOT 19
I hereby certifv that on the 2TII.-day of DEC. 19.9 7. this survey was made nn the ground as per the field notes shown on this survey
+ .e, ct, i -.d accw so f u �e dunensions o[ the subject property and size, location and type of buitdings and irnproveuments thereon,
If any. The s <<c� vh� rr5 II -;—els an -I vi.,ible easements ofwhich I have knowledge or have been advised affecting the subject property.
There arc rio e n.ioe; fnno nts, co I c f�. r protrusions visible on the ground other than those shown.
i)atP I:1E('F;l�nj�I;R 19, 1997
LEGEND
I /T' Steel / Iron Rod Found O
t /2" Steel / Iron Rod Set
Property Line
ii —f Fence — -- —
hain Link /Wire Fence x—X—x—x—X
GF No. --
Scale: 1 " = 20'
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BARRY ,1. ROWEII
4597 /
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777717 11 , 77
77 ' ' <_"777T 7-� I
J 0 B ## 97-5'2)26
11A L)TY
IZ0`' ELL
& Associates, INC.
Surveying h PngineerIng
1301 Flo) Street (( 201 - -�
Carrulll.on, Texas 75006