FEMA-EC950602FPMC -1 (4/94)
�7They With A Beautiful Future BUILDING PERMIT APPLICATION
-
SAY 2 4 95
Print or Type in a Clear, Legible Manner
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Job Address: /
z ce lj Date:
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Lot: Block: A Subdivision: Phase or Section Number:
Owner: 1/ P v �' Ad �l9 Da�er��c.-f Phone #:
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Contractor: Address: 1% �laS TL 7:5 SZ Phone #:
Description of Work to be Done Class of Work: New []Addition ❑ Alteration
❑ Repair ❑Demolition
4rea of Building in Square Feet
First Floor 1256 Garage -4( Value of Work
7 to be Performed
Second Floor qs� Other
Z- GRAY AREA FOR OFFICE USE ONLY
NOTICE
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This permit becomes mill and void if work or construction authorized >s not commenced
within 180 days, or construction cUon on work is suspended a
y , suspe abandoned for a period of 180 days
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Y time after work is commenced.
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I herebycertify that I have read and examined flus
Y application know the same to be true
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and correct. Allvisions o laws and ordinances
Pro ces overran thu t of work will
governing type be
lied w.
with w hether fled here
comp specs mor not The granting of a mit does not asoma to
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give authorit to violate or cancel the
provisions 8i of any other
Pr Y federal state a local
regulating construction or the performance ce of constru lion.
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FPMC -1 (4/94)
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EXISTING 10' MAINT. ESMT.
20' ACCESS do MAINTENANCE ESMT.
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LAGU NA DRIVE
SITE FLAN NORTH
SCALE: c1�'" roil 20, BLOCK �-- 'kANS ARE REVIEWED FOR
Tfdf �+ i• APPROVAL OF SINGLE
E IEWED FAMILY' RESIDENCE ONLY.
OTHER DEPICTIONS OR
12 CALL -OUTS ON PLOT PLAN
B DATE HAVE NOT BEEN REVIEWED
App�ovai c, he pdand specifications shall not AND ARE NOT APPROVED.
be construed tc mean construction in direct con-
flict with tht. A\,i of Coppell Building Codes and
7onino Ord nanr^s
ELEVATION CERTIFICATE °pes y31 193
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.
BUILDING OWNER'S NAME SECTION A PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Avery Edwards Custom Homes POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
922 Laguna- i>r.i_ve COMPANY MAIC NUMBER
OTHER DESCRIPTION (Lot and Bbdt Numbers, etc.)
Waters Ede Phase Two Lot 20, Block A
CITY
CO ell STATE ZIP CODE
TX
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
I. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE S. BASE FLOOD ELEVATION
48o 17O 001 O(in AO zones' use d9M)
E 4-15-94 X N/A
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ 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 I , U 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
The top of the forms is at an elevation
of 4 t3 5 .0 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 I I I I I I,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 I J 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.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
El Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD '29 0 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: ❑ Yes ❑ No (See Instructions on Page 4) UNKNOWN
5. The reference level elevation is based on: ❑ actual construction ❑ construction drawings OF FORMS
(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 Elevatiorp Certificate
will be required once construction Is complete.)
6. The elevation of the lowest grade Immediately adjacent to the building Is: Li -LJ --U IJ 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,LJ 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 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.
/certify that the information in Sections Band Con this certificate represents my best efforts to Interpret the data av '
I understand that any false statement maybe punishable byline or imprisonment under 18 U.S. Code, Section
CERTIFIERS NAME
W. R•= o••�t
Lee LICENSE NU BER (or Affix Seal) ••••••• •
TITLE No. 203 W. R. LEE
Registered Professional Land Surveyor
Y Shields t; Lee Surveyors 9�''°:Ess\°pyo
ADDRES .•••••••
P421 Ferndale A nue D a I I
asTM TSTA
SIGNATURE �� 22FIP
C
GATE t+p
ogles should be maflfof this Certlilcate for: 1) community Official, 2) Insurance (2 �4JN�42-8496.
agent/company, and 3) building owner.
COMMENTS:
NOTE:
This "Elevation Certificate" is valid for item 2(a) only and in so much as changes made on the
face of this document. This Is a certification of elevation of form boards only.
The property referenced hereon is not located In a FEMA 100 year flood hazard as per referenced
panel
The elevations shown were taken from grading plan of Waters Edge Addition. -----
ON
SLAB
A v
ZONES ZONES
Wim_
BASEMENT
ON PILE8,
PIERS, OR COLUMNS
A v
The diagrams above Illustrate the points at which the elevations should be measured in A Zones and V Zo
Elevations for all A Zones should be measured at the top of the reference level floor. nes.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2
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SURVEY PLAT
Address: 922 LAGUNA DRIVE, COPPELL, TEXAS.
LOT 20, BLOCK A, WATER'S EDGE PHASE TWO, COPPELL, TEXAS.
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TO: THE PROPERTY SHOWN HEREON IS NOT LOCATED IN A DESIGINATED
ZONE A (100 YEAR FLOOD HAZARD ANA) ACCORDING TO FEMA MAP:
AVERY EDWARDS PROPERTY 18 LOCATED IN ZONE: .
PANEL : 8o1?O Oo of DATED: 4415-9
I do hereby cartity that the piat shown hereon represents the results of a survey made on the ground by
me or under my directloo and supervision. Visible and apparent improvements to the property found on the
ground ere shown harem. Except as shown hereon there were no visible and apparent encroachments or Q F
protrusions of improvements found on the ground. This survey Is'sublect to all easements of record.
s survey was performed exclusively for the above mentioned parties. Use of this survey for any other ,••'• •E'• �+
purpose or by others shag be at their risk.
c O
SHIELDS AND LEE SURVEYOR :"".W. R..LEE ......
SCALE
DATE - Z- 95
JOB NO. x(2940
DRAWN BY Nr
1421 FERNDALE AVENUE
DALLAS, TEXAS 75224
(214) 942-8496
2038 v
9N �; E SS o �0
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W.R. Lee, R.P.L.S 2038