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FEMA-EC940603 (2)
The City With A Beautiful Future Building Inspections Division BUILDING PERMIT APPLICATION Print or Tvne in a Clear. Leaible Manner Job Address: ,Lf� j/ Date: / in Lot: / Block: Subdivision: % TE Phase or Section Number: f Own � Address:. 7 S--) U Phone #: Contractor: Address: � � 7-, Phone #: Description of Work to be Done Class of Work: ❑ New ❑Addition ❑ Alteration ❑ Repair ❑Demolition pl�(94 Area of Building in Square Feet First Floor /7'z t Garage Value of Work to be Performed ^� Second Floor (v / Other G. GRAY AREA FOR OFFICE USE ONLY NOTICE Permit Fs =Q 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 of abandoned for a period of 180 days at any time after work is commenced. ZoningDistrict, Occupancy Classification: Approved By: Date: 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 w' whether specified herein or not. The granting of a permit does not presume to give authority 'olate or cancel the provisions of any other federal, state or local law regulating constru 'o erformance of construction. u Commenm Signature of>mCactor or Authorrized Agent int Name " ems" Electrical Contractor Plumbing Contractor M hanical Contractor BIR -1 12182) ELEVATION CERTIFICATE O.M.B. No 3067,0077 Expires May 31, 1993 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 I 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 NUMBERI COMPANY NAIC NUMBER 224 Hollywood Drive OTHER DESCRIPTION (Lot and Block Numbers. etc.) Lot 19, Block D, Lakewood Estates CITY STATE ZIP CODE City of Coppell Texas 7501 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): t. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION (in AO Zones, use depth) 480170 0010 D 10/16/91 --- --- 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): X. 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: ' 449 .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 I . 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 450 .,FL 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; 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 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 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: ;X 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 77, 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 2 No (See Instructions on Page 4) 5. The reference level elevation is based on: X 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: 449.5 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: feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement 5/15/94 FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION — SECTION E CERTIFICATION 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 Featurels), then list the Feature(s) 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 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 Atfix Seal) Dan B Ramsey R.P.L.S. No. 4172 TITLE CCMPANY NAME Surveying Manager Jones & Boyd, Inc. ADORESS CITY STATE ZIP 17300 Dal -}gas Parkway, Suite 3010 Dallas Texas 75248 SIGNATURE DATE/ j ^ - PHONE Copies should be made of this C�ificate for: 1) community official, 2) insurance agent/company, and 3) building owner. ON 'MTM ON PILES, SLAB BASEMENT PIERS. OR COLUMNS A V A A V ZONES ZONES ZONES REFERENCE ZONES ZONES �7 r�j(j� _EVEL REFERENCE PEFE?ENCE 3/SE_EVEI EV.I I -LOCO EL ELEVATION .: i - , ,ASE 3ASE _ ADJACENT } REFEIENCE 1 �'0O NATION =_0= GRACE �., _EVEL cLEv•T�CN REFERENCE AOJACEN7 - _EVEL SPACE' I.) +OJACENT .. 1._... ]RACE The ciagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. E!evations for all A Zones should be measured at the top of the reference level floor. E!evations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 FOUNDATION FORM SURVEY TO ALI PARTIES INTERESTED IN PREMISES SURVEYED: This s to certify that have, this date, mode o careful and accurate or the ground survey o' the property iocoted at -224 f1Q//ycu_0,9d %UVO _ n the eCty olf _jfo,Oe// Texas, described as follows: WING lot /9, Block 0_, of Lgkeutrtaol 6gea-C.0 _ _.an addition to the _ Ccty 0-00 d"Ple/ _-_-- - - _ _ -- - _ -� Texas according to the jli" /Q___ thereof recorded in _Xohimv 940S7, Pipe or the HOP . Records of 4%//49 County, Texas. This property does not lie within the boundaries of the 100 -year flood plain according to the flood boundary and floodway Mop No $�L'ZO_QOLODeffective aCOA r_/1o�1�Q/� �XSgPt` p� s/Jlor.+., hereon. ©= 08•/07' f -/0&y` X0 OR/ c 50'9.0.1-i.7 R.= 400.00' Al 40055`6le,Z5.23' s'fUE/ tits! Esai. L.=5.80` �. ySo. z� Vol.94os7� ,G►aL r/c ¢44.27 /o'u(t;l�E E4semtnt Vol ?4057, (y 02 fj i �N tip Lot 20 1 1 Get /9, 81oek Q 224 flol/y«,00d Or. w fop o>c Harr» dem � b. 450.6 vi 4 N ti/dinl L,tie V01-940 7j P , G oz — Lot /S 1 3 / N M 1/ari'ab/e u+idth Aceesa 4 M'� F/ood P/Qin E4sehstnt \ o o VOI 94057, P.sc &02 Z O to l/2'r/.RF.�`PSS�•� 2¢ OZ�S'¢g7 . //-Z e.f CERTWXAT10N \ The plot hereon is a true, correct and occurote representation of the property as determined by this survey, the lines and dimensions of soldproperty being as indicated by the plat; the size, location, OF type of buildings and improvements are shown, improvements P( being within the boundaries of the property, set bock from the property the distances indicated, and there are no encroch ent or protrusions, except as noted. ! DAN 8. RAMSEr - - :e� ; -_ Dion B. Rams■y '• �4, �.�1 Registersd Profss of Land Surveyor No 4172 �,ti.--FE �5��+ (N SU iBE ii. !i iii 1 :•1 1 was • ••■ ■•■ D'@:�ENGINEERS 17300 Dallas Porkwoy, Suite 3010 W an ..:� Dollos, Texas 75248 an WN" ■■• ■r•■■■■■ • DATE Rt'ASiONS