FEMA-EC970617 (2)� N&Od
BUILDING PERMIT APPLICATION
J U ti 0 2 1997
Print or Type in a Clear, Legible Manner
Job Address:�3 � rtA S �O � ,., L N�
Date:
pEpj
Lot: Block: Subdivision:
` t Phase or Section Number:
OwnerAddress:
(:/+
'a. e'X �� � hone #: 2
i -
Contractor: Address:
C%ho e #: '772, 4442--,122?
Description of Work to be Done Class of Work: ONew Addition EI/Alteration ❑ Repair ❑ Demolition
'Z �3? 1�
Area of Building in Square Feet
First Floor Garage
Second Floor a Other 2
Value of Work
to be Performed
GRAY AREA FOR OFFICE USE ONLY
NOTICE
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
regulatin onstruction of the performance of construction.
C
Permit Pee: ,% 0 Receipt Number:�1'
Zoning Distnct:4cGupancy Classification:
,roved By: bate:
MR7
Commen
Sign of Contractor or Authorized Agent Arint Name
'0 • M>EGIi A Ni C
Electrical ntractor Plumbing ntractor Mechanical Coptiactor
FPMC - 1 (4/94)
pL11WA 7'�M
9j
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 Iloodplaln 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
BUILDING OWNER'S NAME
FOk INSURANCE COMPANY USE
POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
.334 /i,�Fq e r,,1S7-o1VL---
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
T' ,�/ Goc,� / OLS L S T.
CITY - --- - — -
STATE ZIP CODE
CO P/o•��L T11:
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
4t:J 0 / 6 0
00110
'/_
'�"� S-^ /
><
(in AO Zones. use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): I . J 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 -1. U feet NGVD (or other FIRM datum -see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicat the diagram number from the diagrams found on Pages 5 and 6 that best
'} describes the subject building's reference level T .
2(a). FIRM Zones At -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of L__LiflP-L51 feet NGVD (or other FIRM datum -see Section B, Item 7).
Q,U (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 L j L_ 1. 1_ .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 _moi .! ' feet above U or
y, below ❑ (check one) the highest grade adjacent to the building.
L), W (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is ! -' feet above [ or below ❑ (check
Q 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 I - j No I_ i Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:. NGVD '29 J 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: PS Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: 2 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.) -0-1111111P411-
6. The elevation of the lowest grade immediately adjacent to the building is: 5 b 4 ..4 feet NGVD (or pt�
Section B. Item 7). /
D CD'
CERTIFIER'S NAME LICENSE NUMBER (o Atrix
TITLE COMPANY NAME
suwy,e yaR ��q•P.P��'ouiE�C ±.h'�v
ADDRESS CITY
SIGNATUREV t-
� � DATE
.. HARRY 4. FOA31.
.S`U1lt'� ZIP
PHONE _
;'.z ) 242
Copies should be m4Vf"e of this Certificate for: 1) community official, 2) insurance agenUcompany, and 3) building owner.
H `
R
SURVEY PLAT H
R
BEING LOT 11 BLOCK 1 OF OLD COPPELL E,9TATP� AN ADDITION TO THE CITY
OF COPPELL, DALLAS COUNTY, TEXAS. RECORDED IN VOLUME 96020, PAGE 2443,
P.R.D.C.T.
BIG CEDAR ADDN.
VOL. 92125, PG. 3455, M.R.D.C.T.
CALLED 85.
1/2" I.R.F.
1,9 MEAS. 85. 04
82"2'58" _ _ _
SANI. SEIr. ESMT.
1/2" I.R.F.
N
LOT 11
BLK. 1
m
8'2
10.4
W
•`�'
Co
o
co
FORMBOARDS
ap
p
8.2
TOP OF FORMS ELEV. = 505.2
�p
Q
W
a
ol
LOT 10
LOT 12
o
9.0 lo
ol
lo
25' B.L. lo
N
on
90100'00"
10' UTIL. ESMT.
3/8" I.R.F.
64.66 1/2" I.R.S. 15.34 1/2•• I.R.S. oo
REFERENCE BRG.
N 88'47'57" E•= 525'
334 HEARTHSTONE LANE
I hereby certify that on the127-Miday of JUNE-
19 97 - 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, lo
If any. The survey shown all easements and visible easements
of which 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.
��OFT
�AG�JT�jpeO.i-tP
Date . JUNE 17, 199797-2922
JOB #
HARRY J. ROAELL
GF No.
. . 4597
LEGEND 0 Scale: 1"
= 25's°¢ HARRY
1/2" Steel / Iron Rod Found O
1/2" Steel / Iron Rod Set 0R
0 W E L L
Property Line By
& Associates, INC.
Wood Fence — - — - — - — —
Surveying & Engineering
Chain Link / Wire Fence x—x—x—x—x
1301 Elm Street Ste. 201
Overhead Electric — E— E— E —
Carrollton, Texas 75006