FEMA-EC971230i
The City With A Beautiful Future BUILDING PERMIT APPLICATION
-
' . 41997
Print or Type in a Clear, Legible Manner
Job Address: ,L' eSTo N� W I11►- �1A— $?/ Date: �EG SPT
Lot: 15 Block: 1 Subdivision: 01-D COPPECL 657)-9TgSPhase or Section Number:
[Owner St)e6 (.,SCS M Aomcs Address: F0. ?9 pX 1364 e4jpRcidl Phone #: 9 72 - 393-26%8
Contractor: MM6 Address: Phone #:
Description of Work to be Done Class of Work: Da New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
S/11/l' t_E Filmiu.� Z�Ti9c1�E�
Area of Building in Square Feet
First Floor '2201)
Second Floor
NOTICE
Garage �9d/
Other `
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 conAtruction of the performance of construction.
Signature of Contract r or Authorized Agent Print Name
-Nir rld rin' e)e U -S )qj#
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 14194►
Value of Work yf oo
to be Performed " �� 8.000'
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
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.
BUILDING OWNER'S NAME
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I
POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER ' COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
/-07" /$ �G0e / off= OLy �O�jo.E'CG E ST.S.
CITY STATE ZIP CODE
7-x.
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 U 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 .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
e `s"'bf [_ 1 6104.LZ 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 .❑ 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 . ❑ feet above ❑ or
Qbelow ❑ (check one) the highest grade adjacent to the building.
Q
(d). FIRM Zone AO. 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. 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
O 3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD '29 ❑ Other (describe
tl 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
Q equation under Comments on Page 2.)
Q, 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: ❑ .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 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.
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 Affix Seal)
eow_ 4 L 4s 9
TITLE COMPANY NAME
hWA4AV I/ le6WZa— 69111
ADDRESS CITY STATE ZIP
,30 r e TX Soot
SIGNATURE B �ZDAPHONE
&D ^ 9'7 1 72 Z7� Z s-�r nr 7
Copies should be madq this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS:
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
OAr 64UE4
VOAD
(in AO Zones, use depth)
6o1WPEV1N,c
c)11245,ffK
,EGEV 5701.94
1
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 U 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 .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
e `s"'bf [_ 1 6104.LZ 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 .❑ 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 . ❑ feet above ❑ or
Qbelow ❑ (check one) the highest grade adjacent to the building.
Q
(d). FIRM Zone AO. 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. 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
O 3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD '29 ❑ Other (describe
tl 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
Q equation under Comments on Page 2.)
Q, 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: ❑ .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 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.
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 Affix Seal)
eow_ 4 L 4s 9
TITLE COMPANY NAME
hWA4AV I/ le6WZa— 69111
ADDRESS CITY STATE ZIP
,30 r e TX Soot
SIGNATURE B �ZDAPHONE
&D ^ 9'7 1 72 Z7� Z s-�r nr 7
Copies should be madq this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS:
A161€/V e#%I?"I
.SQYA��
OAr 64UE4
VOAD
*VEA
6o1WPEV1N,c
c)11245,ffK
,EGEV 5701.94
145.00'
N
I
0
---- —20' QIdg. Line— N
Conc.
DrivP
er1r \
House Is Parallel
W/ North & East
Property Lines
01
1 1,91
L\\
ao
Two—Story K)
Single Family cD
gyp. .t• \ \
P'`\`\
PLANS ARE REMWED FOR \\`\ � 5'
APPROVA:.L OF SINGLEFAMILY
; y'
CAT
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Mit�Rn: .' syr ' 4'ED. \ �\
CITY OF COPPELL
REVI WED
BYVf'E P C
Approval of fire pians and sped#ie�i.st"s $hail rat
be construed to mean iBuilding codesand, construction
Zortic►p
With the City of Copps
0(dimces.
FORM $30A"
SURVEY REQUiRED
> y,
SME T CUT
- - - - - - - - - - - r - -
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11
Front Bldg. Line
FiE.M. �. laETUrt��iN�ff,} q
mac.
Walk
56.51'
M
PLOT PLAN
SCALE 1/16"= 1'-O"
LOT 15 BLOCK 1
OLD COPPELL EST.
COPPELL, TEXAS
HR SURVEY PLAT Hg
BEING LOT 15 BLOCK 1 OF OLD COPPELL ESTATES AN ADDITION TO THE CITY OF
COPPELL, DALLAS COUNTY, TEXAS. RECORDED IN VOLUME 96020, PG. 2443,
P.R.D. C. T.
_.--amokZ
MARY STONE MYERS
BIG CEDAR ADDITION VOL. 73005, PG. 2820, D.R.D.C.T.
VOL. 92125, PG. 3455, P.R.D.C.T.
PARK LAND
52'38'23" 145.00 1/2" I.R.S.
3/8" I.R.F.CQ
\
/ \ 20' B.L.
LOT 15
\ \ \ BLK. 1
yd.��• ? �,��Q FORMBOARDS
CV
LOT 16
Pq
e.1 a
CT ,�
\ 1/2" I.R.S.
LOT 14 56.51
RAD.- 60'
3/8" I.R.F.
318 HEARTHSTONE LANE
I hereby certify that on the22ND.day of DEC- " 19-2.x, this survey was made on the ground as per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and size, location and type of buildings and improvements thereon,
if any. The survey shown all eaeements and visible easements ofwhich I have knowledge or have been advised affecting the subject property.
There are no encroachments, conflicts, or protrusions visible on the ground other than those shown.
0.
Date . DECEMBER 22,1997 �,SGI§P�
`� JOB # . 97-5412
HARRY J. ROWELL
GF No. 4597 '
G LEGEND O Scale: V= 25' s Rv °¢ HARRY
1/2" Steel / Iron Rod Found O
1/2" Steel / Iron Rod Set 49 ROWEL L
Property Line B Y : & Associates, INC.
Wood Fence — . — • — . — . — 49 Surveying & Engineering
Chain Link / hire Fence x—x—x—x—x 1301 Elm Street Ste. 201
Overhead Electric — E— E— E— Carrollton, Texas 75006