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FEMA-EC971020►�7 BUILDING PERMIT APPLICATION Print or Type in a Clear, Legible Manner 't L•' 'J tJ �JU Q D D C -T 1 11997 Job Address: 3/O 1J ! 1 m i4 3-3�9 Date: Q Lot: Block: Subdivision:ES Phase or Section Number: Owner Address:© Phone #: Contractor: ® Ao Address: Phone #: G 2- Description of Work to be Done Class of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition fi A6,1fte.S tAl Area of Building in Square Feet First Floor 2 -� Garage /' / Second Floor 2- Other f (� Value of Work to be Perforrned S GRAY AREA FOR OFFICE USE ONLY NOTICE Permit Fee: 1.1----- Receipt Number: 94(` 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 Zoning District: Occupancy Classification:' 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 Approved B ' >� 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 Goll me give authority to violate or cancel the provisions of any other federal, state or local law regulating construction of the performance of construction. Sig re of Contractor or Authorized Agent Print Name Aol!4 "& A&, 44L Electrical Contractor Plumbing Contractor ec ianical Contractor FPMC - 1 (4/94) 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 LOMB). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOh 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/OI h�.E�5Wr116ro�V,6_ "&,& OTHER DESCRIPTION (Lot and Block Numbers, etc.) LOT 17 QLDCeLD 061000,641- ES TS . CITY STATE ZIP CODE 19 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 Roo4 D oye e aey rC7 od�o �_ 4 -is -94 1 1 '009.=.- (in AO Zones, use depth) 4*6 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 _ / . 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[ feet NGVD 1 Isp 131.E or other FIRM datum—see Section B, Item 7 .oowo* ,6_•e V. 50 A zo w� s Tq��N ( ) � cv.BsT' LBvFL of FDf'/rlQogQDS (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 .0 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 ❑❑ . ❑feet above El 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 4 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 Q 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 m the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion Q equation under Comments on Page 2.) t� 4. Elevation reference mark used appears on FIRM: El Yes K No (See Instructions on Page 4) If 5. The reference level elevation is based on: W 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 W will be required once construction is complete.) ~� 6. The elevation of the lowest grade immediately adjacent to the building is: L I I I 1 1.0 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 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 Features) 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 dat a�ilable. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, S�`F CERTIF�IJER'S NAME `LICENSE NUMBER (or Affix Sea]) TITLE COMPANY NAME • • • • • • • • • • • • • ' ' ' ' ' " ` ' _csoft/,EYole \�s•• 4W7 ADDRESS ITY O Aid, ••'d " ZIP l �jD l 67 roeC'.�iPiPd GLTD�✓ %1! 7500 SOV, •'- SIGNATURE ­'.,DATE PHO /O —20 -917 Z,97!?) 242 -5479 Copies should be maLWof this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: 156AZg/Yw)l SQU a6 c T `in "** oN So arhoMS T G41i2A/A-.e Ovc ��P/OG.E ON Be'y/yeL Roo4 D oye e aey P.6yiN� oee2n ? .EC EY = 6 -oz . (0 0 iC4 STREET CUT PLANS ARE REVmwr, n POR • APPROVAL OF SINGLE; FAP: TILY RESIDE, ..It NCF. , ONLY OTHER . T DF;i'IC 'IONS k wx CALL -OUTS ON PLOT PLAN FIAVE NOT BEEN REVIEWED AND ARE MQJ: APPROVED. CITY OF COPPELL. '. IE Y Approval of the plans and p�pecifications shall not be construed to mean construction in direct confUct With the City of CoppeN Building codes aad Zoning Ordinances.