FEMA-EC940216 (2)® wm4m/ �713 a ,liy n (`(o12i1
The City With A Seautitul future BUILDING PERMIT APPLICATION �' 2 o s3
Building Inspections Division
Z Print or Type in a Clear, Legible Manner
Job Address: Z 2jNate: Ct
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la
Lot:j 1 Block: Subdivision. ��� QUA, Phase or Section Number:
Owner: Address: F # �O a{ p Phone y: 4 SS. 4
Contractor: n M� Address: Cid Phone y:
Description of Work to be Done Class of Work: OtNew ❑Addition ❑ Alteration ❑ Repair ❑Demolition
aF 2
of Biplding in Square Feet
First Floor Z 3�3
Second Floor
Garage 66
NOTICE
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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
Z01
days at any time after work is commenced.
AP
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 construction or the performance of construction.
Co
4U lui ckAt5L
Signature of ContractA or Authorized Agent Print Name
Electrical Contractor Plumbing Contractor Meckanical Contractor
BIR - 1 (2102)
Value of Work
to be Performed so Grc�
GRAY AREA FOR OFFICE USE ONLY
ELEVATION CERTIFICATE O.M.B. No 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Eltprres May 31, 1993
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 MAIC NUMBER
236 Hollvwood Drive
OTHER DESCRIPTION (Lot and Block Numbers. etc.)
Lot 16, Block D, Lakewood Estates
CITY STATE ZIP CODE
City of Coopell Texas 75019
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3.
DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
7UFFIX4.
(in AO Zones, use depth)
480170
0010
10/16/91
---
---
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 2L, 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!..5 '' 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 1 .
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 1 450 A - 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 X 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 10/15/93
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 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.
If certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available.
I 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)
_ Dan B. Ramsey. R.P.L.S. No. 4172
TITLE COMPANY NAME
Surveying Manager Jones & Boyd, Inc.
ADDRESS CITY STATE ZIP
17300 Pstlas Parkway, Suite 3010 Dallas Texas 75248
SIGNATURE
PHONE
Copies should be made of thiorCertificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
ON WrrH ON PILES,
SLAB BASEMENT PIERS. OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
_EVEL REFERENCE
aEFERENCE BASE __VEL 01T��L
=LOGO
ELEVATION - I BASE
BASE-LC
ADJACENT REFERENCE ELEVAT ON
='_OCC GRADE _E'JEL
BLEYATiON REFERENCE AWACENT
_EVEL GRADE
ADJACENT
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
FOUNDATION FORM SURVEY
TO ALL PARTIES INTERESTED IN PREMISES SURVEYED:
This is to certify that I have, this date, made a careful and accurate on the ground survey of the property located
at _ 21(& `►'-Qff"aZ 0,n?,Cs____—______- in the f'r%c�_�'gvR�(1___________-Texas, described as follows:
BEING Lot 14., Block .lZ, of okewovol _______________________,an addition to
the _ �f_�p,� Texas according to the _H_af2_ thereof recorded in
of the .flap__ Records of Qo%LasN County, Texas.
This property does not lie within the boundaries of the 100—year flood plain accor ing to the flood boundary and
floodway Map No. 4801ZQ QQZQLL_ effective_____. Ile"/QF
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CERTIFICATION •��'
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The plat hereon Is a true, correct and accurate representation of
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the property as determined by this survey, the lines and dimensions tr lit P!' � 1,10
of said pproopperty being as Indicated by the plat; the size, location, �,` 1� 014 ��y'�7 e*
type of bufidings and Improvements are shown, improvements �v��
being within the boundaries of the property, set back from the �a \`r/k;'�ea3o�4
property lines the distances Indicated, and there are no q�p h Jot,
encroch�s or protrusions, except as noted. Z"/,e
Dan B. Ramsey
Registered Prof
SCALE:
1"-20'
Land Surveyor No. 4172
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JONES & BOYD, INC.
CONSULTING ENGINEERS
17300 Dallas Parkway, Suite 3010
Dallas, Texas 75248
214-248-7676
DATEDRAWN PROJECT
/O/P8/93 16.4/,V. XA306
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REVISIONS
SENT BY:Jones & Boyds Inc, 8-30-93 ; 9:0bAM 3922999-+ 214 490 76234 3
JOB ##0026
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SCALE: 1 20'
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1 1"
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GS 48.70
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re 8Q10
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re 30.10
Lot Area: 12933
Sq.Ft.
Type 'C' Drainage
Fence Length: 198' I
4^ _
19.r
Includes 1 Gate
0249A
1 1"
FF 50.20
GS 48.70
(saw;
re 8Q10
M. i0}
re 30.10
Lot Area: 12933
Sq.Ft.
Type 'C' Drainage
Fence Length: 198' I
t
Includes 1 Gate
date
1
08/12/93
ALL ELEVATIONS ARE FINAL
GRADE UNLESS OTME"SE—j
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► 1 � f .�
NOTED.EXID THUS AXES)
rev
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08/27/93
Trendmaker Homes
5720 L8J Freeway, Suits 510
Gallas. Texas 75240
A.Trhasu«r (214) 458-5909
subdiv
LAKEWOOD ESTATES
Ibt blk
16 D
address
236 HOLLYWOOD DRIVE
city plan
COPPELL, TX IL3249A
-