FEMA-EC941103 (2)® [ A
The City With A Beautiful Future BUILDING PERMIT APPLICATION
Building Inspections Division �,/
�l � j % Print or Tvpe in a Clear, Legible Manner
V`
Date: v/ 014 -
27
Phase or Section Number:
04
� Phone#:
, 0;7�
Contractor: Address:
Phone #:
Description of Work to be Done Class of Work: ew []Addition
❑ Alteration ❑ Repair ❑Demolition
Job Address:
Date: v/ 014 -
Lot: I Block: � Subdivision: I ,I AT�SD4�
Phase or Section Number:
Owner: G/Lt Address:5,A�
f0.
U 1 �'t
� Phone#:
, 0;7�
Contractor: Address:
Phone #:
Description of Work to be Done Class of Work: ew []Addition
❑ Alteration ❑ Repair ❑Demolition
Area of Building in Square Feet
First Floor ��T] Garage ZOO{ Value of Work �dt�
to be Performed 2 ,
Second Floor ���' Other � �}p
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
regulating construction or the performance of construction.
6Tc� I. l �OVIB�J
1L►1UG'
Permit Fee:
77 7
receipt Number:'
Zoning District:
Occupancy Classification:
Approved By:
Date: Z,
Comments:
Signature of C tractor or uthorized Age t Print Name
�G..Q vu alt
Electrical Contractor Plumbing Contractor Me anical Contractor
BIR - 1 12/821 0
ELEVATION CERTIFICATE O.M.B. 1V03067-007
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires 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 LOMB).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNER'S
FOR INSURANCE COMPANY USE
�j�NAME
C-0(4 N J X ( Ce -,A/ lfnoeS POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
1_30 1_A6,(1AJA 6)et VC COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
$l K fi � s � 6� Pl rs�rzv o GOP Ka.� S LvwJTY _1:
CITY
STATE ZIP CO E
T 7.so
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
V Q 17 O (� p' p 007_ I 1► Q (in AO Zones, use depth)
LLLL
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: ❑ 45TO J lb I 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 L 1 04 -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 L ❑.❑ 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 LL . 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: 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 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 YNo (See Instructions on Page 4)
5. The reference level elevation is based on: D a tual 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: I I`tI51� , A 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: L I I I I I , ❑ 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 breakaw way wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), t .1i t •Fe ) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still lin3�edh T't
1 certify that the information in Sections B and C on this certificate represents my best efforts to interp •M++be,avarlAb�le:••••
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Cod , R II FETTY
........Y I
,r.v9 5034 %Q
CERTI IER'S NAME LICENSE NUMB R (or Affix Seal) U Rv
At0GD D, 1:�ETj'/ Irl: 60 3
TITLE/ COMPANY NAME
Dr't ,q( � ASSoC/ATZS 640M 5uccL-Y1l4
ADDRESS CITY STATE ZIP
P 0 . , Ox 28 oS3 8 bAwt5 -Y 7 SZZB
SIGNWA�/• C/����% !!�. /✓077 7 / /!9Y' PHONEj�i(q ) T"7_10
Y
Copies should be made of this ebrtificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE BASE LEVEL
REFERENCE
LEVEL FLOOD
LEVEL
ELEVATION
^FF?;ti'
'a. .:::;:.;:•F:^'
BASE
BASE
ADJACENT:. �' REFERENCE
FLOOD
FLOOD GRADE `i:% LEVEL
ELEVATION REFERENCE ADJACENT •
ELEVATION
LEVEL GRADE•.:.
::.5".::..;.i: �.:..::•'•:..:':: `:':: :'•S:
ADJACENT:;.
" m
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
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'Pl�rl�
.k.t.Ml.A. LETTERIRED.
MII3 WM f f. '
CITY OF COPPELtiL
� LAGLINk-DR-[V.E REVIEWED
a oar
Approval OT of ns and specifications shall not
be construeei c ,jean construction in direct con-
flict With the r,!bv .m- Gopoell Building lodes ani"
Q.iT= 01 AM Zoning i'Avdinwr ,,is
QT -....i$_-. BLOCK A
IATERS__ED-GE.-_PHASI__TW-0
.OP-PE.LL,DA LLAS__ Mg -.__T -EX AS
1
♦ DESCRIPTION
Being Lot 18, Block A, of WATERS EDGE PHASE TWO, an Addition to the City of Coppell,
Dallas County, Texas, according to the Map thereof recorded in Volume 94144, Page
2344, Plat Records, Dallas County, Texas.
i
i
N TE: According to F.E.M.A. Flood Insurance Rate Map. Community Panel No. 48017000010D,
al
ted Oct. 18, 1991 this property lies in Zone X. This property does not appear to lie
w�thin a 100—year flood plain.
B� ARING SOURCE: RECORDED PLAT
1\
i
I
i
LOT 17 RF ;
14 7 76
N g �� - 00 E '''�
o
SDnNE LOT1— �'
J 1R n 9 my ' I Z
1 31 , 2 . R o.
a
A
11\
LINE
L /
L 2
L 3
L 4
L 5
a
46
N , \ Mv+< 6 :/' a FORM BOAR�R ! VE 4 J
\�
.M\ �' 930 LA Fowls a_ s OF•.
e's r.F.�-
a �
~ �G SAF'• 9F
N o c14HAROLD D. II I
FETTY
.MMM••N••1•N••• TY II
1 ; �•
\c7 1 } 48 �� tRF 90V. PJr0�Q�.: Q'
v� p SURq
\N 19 — W 37.07
G 8.00 1, Harold D. Fet.ty, III, Registered Professional Land Surveyor, State of Texas, do certify
S $ that the plat hereon is a true, correct and accurate representation of the property
.,54 as determined by survey performed on the ground, the lines and dimensions of said
W,tt+E` LOT 19 property being indicated by the plat, the improvements are within the boundaries of
the property set back from the property lines the distances indicated and there are
no VISIBLE EASEMENTS, ENCROACHMENTS, CONFLICTS OR PROTRUSIONS, except as shown
on the above plat.
BEARING DISTANCE IWrold D. Fetty III, R.P.101. No. 5034
N 26.33.54'N 29.05'
N /6.58'57"N 37.13'
N 65.23.06 -E 1.67'
N /9.26'51'W 4.41'
N 08.35.26 ' N 4.82'
STO VA LL & A SSOCIA TES SI,RV6.1,
im m2409 • to
POST OFFICE 6O( 28MM 0 DKLAS, TOMS 7.,228 0 MOW (214) 407-1D44
v2- RS \
WITNESS AT ►2.34'
DESCRIPTION
Being Lot 19, in Block A, of Waters Edge Phase Two, an Addition to the Cite of Coppell,
Dallas County, Texas, according to the Map thereof recorded in olume 94144, Page 2344,
Plat Records, Dallas County, Texas.
NOTE: According to F F.M.A. Flood Insurari�e Rate Map Community Panel No. 480170 0010D,
doted Oct. 16, 1991 thiY property lies in Zone X. This property does r,ot appear to lie
W0.hin a 100–year flood plain.
cn
Lot 18 1/2-
137 07
/2-137.0c�
\ N �O M
623 : a
.
\ o.�
t
C)
z
—2>
4.0 140 N 1.
w kn ,
FORM BOARDS
926 LAO W DRIVE 6.2 ' e+
Sb\ Loi 19 i� 1C8 111
% Block A Top of former -456.48
^-SAKE
LAKES OF COPPFLL
BONE OMUIERS ASSOC1ATYON
V A
f Srow
WALL FIND 'X'
BEARING SOURCE RECORDED PLAT
I G9Fo9
HARD:LO D. FETTY III
.M..NNN.Hax„.,Ns � Hs
5034
SURD
112,37
I, Harold D. Fet.ty. III. Registered Professional Land Surveyor. State of Texas, do certify
\ ; that the plat hereon is a true. correct and accurate representation of the property
as determined by survey performed on the ground, the lines and dimensions of said
Ilk property being indicated by the plat, the improvements are within the boundaries of
9. Lot 20 the property, set back from the property lines the distances indicated and there are
R` no VISIBLE EASEMENTS, EN( RO.ACRMENTS, CONFLICTS OR PROTRUSIONS, except as shown
on the above plat.
0-
s� arold D. Fetty III, R.P.1.6 No. 5034
' 0
s
S T 0 V A L L& ASSOCIATES --= - - SURVEYORS
ad 9W F� am WU 111PUMM11N LMQ 1 Joe
POST OFFICE 280538 • DALLAS, TEXAS 75228 0 PtM (214) 407-1044
0 % 1 I
,M — F
am 11111IN011111 U WLL 111= W#A Adpftt
POST OFFICE 280538 • DALLAS, TEXAS 75228 0 PtM (214) 407-1044