FEMA-EC961213;i� "ff." ��= �
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The City With A Beautiful Future
BUILDING PERMIT APPLICATION
-?/,71..z 4 Print or Type in a Clear, Legible Manner
DEC 1 2 Pq
Job Address: JA),
Date: /,7,/ l f /9 (151
Lot: /+Block: / Subdivision:
Q%� Phase or Section Number:
Owner 4ka BO) ld« Inc Address: ��(p ��� Phone #: a�� � � �� �` �3 A
Contractor: Address: ����}�
!-' Phone #:
Description of Work to be Done Class of Work: )(New ❑ Addition
Alteration ❑ Repair ❑ Demolition
/❑
WzLv, 6rjj
Area of Building in Square Feet
770
oc)
First Floor Garage
Value of Work .� j
� / �f'
4,)--
%
to be Performed �+
Second Floor Other
��lsG S GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee:
Receipt Number: /
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.
Approved By:
Date:
I hereby certify that I have read and examined this application and know the same to be true
Comments:
and correct. All provisions of laws and ordinances governing this type of work will be
herein or not. The of a does not presume to
complied with whether specified granting permit
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction of the performance of construction.
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Signal a of � ontractor Authoriri`A•gentt, �/ Print Name
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Electrical Contractor P1 bing ContractoMecharlwal Contractor
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6' CEDAR SD. BY SD.
FENCE W/ MTL. POSTS
322 HEARTHSTONE LANE
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JIMMY W. POGUE
REGISTERED PROFESSIONAL LAND SURVEYOR NO. 1722
3510 MARVIN D. LOVE FRWY.
DALLAS, TX 75224
PHONE (214)371-0666 FAX (214)371-9900
TO: HOLMES BUILDERS
CITY OF COPPELL
RE: 322 HEARTHSTONE LANE
LOT 14 BLOCK 1
OLD COPPELL ESTATES
COPPELL, DALLAS COUNTY, TEXAS
This is to certify than the top of form elevation for the lowest floor of the
referenced structure is 503.93 above mean sea level. The
following benchmark was used in determining the form elevation.
BENCHMARK: SQUARE CUT ON SOUTHEAST CORNER
F CONCRETE BRIDGE ON SOUTH
ELEVATION= 501.94'
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PAULA. HIDALGO
REGISTERED PROFESSIONAL
LAND SURVEYOR NO. 4490
JOB NO. 63212
O.M.B. NO. 3067-0077
ELEVATION CERTIFICATE ExpiresMay 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 I FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME
STREET ADD_S� jlncluoipg Apt., Unit, Suite and/or Bldg. Number) PR P.O. ROUTE AND BOX NUMBER
POLICY NUMBER
COMPANY NAIC NUMBER
OTHE DR ESCRIPTION LT (L� t aid Block tubers, etc.) / I OL ,e—��
CITY n _^^^ 'r`-tl l "� �_ _ STATE/lam ZIP CODE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
011 n F Ftx_
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
1
n
//T\
(in AO Zones, use depth)
O/ ,Z
1 �V��L
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): XNGVD '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 . ❑ 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 J__ .
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 I I M .91 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 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
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 ❑_I . 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
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 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.)
4. Elevation reference mark used appears on FIRM: El Yes 0 No (See Instructions on Page 4)
5. The reference level elevation is based on: X dctua cons ruct on El 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—Ll0" . 01 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 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
,-Ze) � � -
SECTION E CERTIFICATION
This certPication 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),Vi—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 8 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.
NAMEZoo' LICENSE N M ER (or Affix Seal)
- � W
ADDRESSSTATE ZIP
AS
SIGNATU� 71 ATE (PHONE. -Q
Copies should be made of this Certificate for: 9)-community,offictal, 2) insurance agenVcompany, and 3) building owner.
COMMENTS:
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL
REFERENCE
REFERENCE BASE
LEVEL
LEVEL FLOOD
ELEVATION
• 'filo
• `.'�
BASE .:i�:•. �:'::::: :'•: �•.; :• .•';?. REFERENCE
ADJACENT.;:
BASE
FLOOD
..,,4;,
FLOOD GRADE' ^� LEVEL
ELEVATION
ELEVATION
REFERENCE ADJACENT
i}1
LEVEL GRADE`
'::•'i:;::r.;.:::•i:::i.:;;::i::::. ':ADJACENT_..
::')i.;:. r::.:•::;:, ::• •:,
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 JIMMY W. POGUE, INC.
This is to certify that I have, this date, made a t ireful and accurate survey on the ground of property located at
322 IIEARTIIS'rONL LANE' COPPRLL
No in the cit} Tex"
1-ot No. Block 'k No. City Block No.
'i,.STA'iF*S
of OLD COPPILL .,,------- an addition to the
City of COPPELL, DALLAS COUNTY, Texas, according to the PLAT thereof
i-r-orded in Volume P4`-. 244.3 - MAI' Recows-.— DALLAS County, Texas.
NOTE: I DID NOT SEARCH THE COUNTY RECORDS TO DETERMINE EASEMENTS
OR RECORD TITLE. ALL INTERESTED PARTIES SHOULD EMPLOY A
TITLE AND ABSTRACT COMPANY TO DETERMINE EASEMENTS AND STATE
OF TITLE AND OWNERSHIP TO THIS PROPERTY.
20' REAR YAR
13
10' UTILITY
EASEMENT
25' BLDG.
LINF
10'UTIL.
ESMT.
7'01::e 'ST e
S 830 04' 330' E REFERENCE BEARING
FROM PLAT
10' SANITARY SEWER
a C) n J EASEMENT
20' REAR YARD
/� P -90 1 44
OLAPP
**"a
7'he t.Srryrrsenistw, t the properl), as cleternutwt by on the stouixi suive-, the lines PAUL A It IDA I,G0
andn, rni!ors saidprojK,ty being As inlwate.-, !y the ptat ' tkwsize locati.-n and i�pe of buildings an4 Rl;'(.;IST",EI"ED PU0FESS10NAT,
Iniproveinents art as showr ail impro,enwnf , he�v g within th# r�iundariet 4 the properly, set hack from
Property lint.: the disiii^ce inilkswil, and no, the dist&"c es fr,•m the neatest intersecting street, or road. LAND SURVEYOR NO. 4490
is ai sbowt, on said plat, all cornu monumr*As are as w),,wn.
THERE ARE NO ENCROACHMENT OR PROTRI 'a$ ONS.
This %,urve,v was performed is . onnection with -!w trarvAction
0 JIMMY W. POGUE, INC.
described a, GF. No
of HOLM'L-,.S-,!3U1LDFRS 3510 MARVIN D. LOVE FREEWAY,
DW-_ 12 _-19 96 Company. Use of ClIms vATey for any odmir or b mity DALLAS, TEXAS 75224
------ Tift (' PW" y
other pecuft " be strictly prohibited w this auvey is a copyr4m PHONE (214) 371-0666
6 12 1 2 o*nW by Jimmy W. Fogme. Le., mad aft other awe we forbidden,
X's No undw-iii poor wrimn consent of Jim" W. Pepsa, Imm.
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