FEMA-EC950615r
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,,,eCity With ABectiMAY 1 2 95
Future BUILDING PERMIT APPLICATION
Building Inspections Division ;
/ 7 7 3 t �Z- Print or Type in a Clear, Legible Manner
Job Address: i (�� i� -� Date:��
i
Block: Subdivision: , i .j / Pha or Section Number:
Lot: A �,l1 ��ti�J _� C � L ��: �U�
Owner: Address: �r Phone #:
Contractor: 1 Address: I�� r �� Phone #:
Description of Work to be Done Class of Work:7b-New []Addition ❑ Alteration ❑ Repair ❑ Demolition
of Building in Square Feet
First Floor
Second Floor
Garage Value of Work
to be Performed (a ���
Other
_�J-
GRAY AREA FOR OFFICE USE ONLY
NOTICE rermn >ree;17
This permit becomes null and void if work or construction authorized is not commenced Zonin District:
within 180 days, or construction on work is suspended or abandoned for a period of 180 g
days at any time after work is commenced.
Approved B .2
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 COm171811t
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.
Signature oir/Corittrictor or Authorized Agent Print erne
r
Electrical Contractor Plumbin ontractor Mechanical Contractor
BIR -1 121921
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Ave itzvt"zvTD FOR
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SITE PLAN
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FAIRWAYS AT RIVERC✓-W'e
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1508 KINGSMILL COURT
O.M.B. NO. 3067-0077
ELEVATION CERTIFICATE Expires May 31, 1"6
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 I
BUILDING OWNER'S NAME I POLICY NUMBER
Unit, Suite and/or Bide. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY NAIC NUMBER
OTH R DESCRIPTI (Lot and B Numbers, etc.)
�
1 �
STATE ZIP CODE
cITY6
1+�1�F— ( :x
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions): mine IFF L T
i. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
(in O nes, use depth)
4PWlO
ti
�_
,D
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): KNGVD '29 LJ Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established 8 BFE for this building site, indicate
the community's BFE: I I I I I I. LJ feet NGVD (or other FIRM datum—see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicale the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level 1 .
2(a). FIRMZ nes A7 -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of LJ�1J.� feet NGVD (or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1430, 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 l l l l l ,LJ 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 L1J . LJ 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 1 1. LJ 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: 9 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 8, 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:: -%Q Yes ❑ No(See(See Instructions on Page 4)
5. The reference level elevation is based on: ;tcle c At� orf ❑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: L L 1 .15feet 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 .L 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
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 Ai—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 S - Distinguishing Features—If the certifier is unable to certify to breakaway/non-b��r�lga�kaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Fatur+e(s 11`ii';tFi `'I"e t"`�re(s) not
included in the certification under Comments below. The diagram number, Section C, ItA;` u '
1 certify that the information in Sewn B and C on this certificate represents my best efforts /able.
I understand that any false statement may be punishable by fine or imprisonment under 18
NAME LICENSE NUMBER ( • ��
O
.. COMPANY NAME
CITY 1 ' M ✓ -.r. � STATE _ _ ZIP
SIGNATURE
Copies should be made of this Certificate for: 1) community official, 2) Insurance agenVeompany, and 3) building owner.
COMMENTS:
ON Wren
SAI "8E11VENr
A V A
ZONES ZONES] ZONES
wst ....:.... -.. -
FLOOD ""•`'" ADJACENT
ELEVATION REFERENCE ADJACENT GRADE
LEVEL GRADE
ON PILES,
PIERS, OR COLUMNS
A V
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 -careful and accurate survey on the ground of property located at
No. 1508 KINGSMI LL COURT- _ in the city of, COPPE L - Texas
Lot No. *4 6 , Block No. A City Block No. _
of THE FAIRWAYS AT RIVERCHASE, an addition to the
City of COPPELL, DALLAS COUNTY, Texas, according to the MAP thereof
recorded in Volume 93056 Page 2367 , MAP Records — DALLAS _ County, Texas.
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SURVEYO#'S NOTE: I
DID NOT SEARCH THE
COUNTY RECORDS TO
DETERMINE EASEMENT
OR RECO*D TITLE.
ALL INTERESTED
PARTIES SHOULI),,,
EMPLOY A TITLE AND
ABSTRACT COMPANY TI
DETERMINE EASEMFNT;
AND STAVE OF TITLE
AND OWNBRSHIP TO
THIS PROPERTY.
05
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� diL
S 83°37' 31" E (REFERENCE BEARING FRff PLAT) 4
rA
KINGSMILL' COURTS
The plat hereon is a true representation of the property, as determined by on the ground survey, the lines
and dimensions of said property being as indicated by the plat; the size, location and type of buildings andPAU L A. HIDALGO
improvements are as shown, all improvements being within the boundaries of the property, set back from
property lines the distance indicated, and that the distances from the nearest intersecting street, or road,REG I STERED PROFESSIONAL LAND
is as shown on said plat, all corner monuments are as shown. SURVEYOR NO. 4490
THERE ARE NO ENCROACHMENTS OR PROTRUSIONS
This survey was performed
Scale 1 ° =20' FOR: JIMMY W. POGUE, INC.
Dau 6-5-95
Joe NO 60511
HOLMES RTI T TMER S 3510 MARVIN D. LOVE FREEWAY
Use of this survey for any other purpose or by any DALLAS, TEXAS 75224
other parties shall be strictly prohibited as this survey is a copyright PHONE (214) 371-0666
owned by Jimmy W. Pogue, Inc., and all other uses are forbidden,
without prior written consent of Jimmy W. Powe, Inc.