FEMA-EC960903Jul 1 6 96
The City With A Beautiful Future BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Job Address: ` '1 Date:
Lot: \ Block: Subdivision: Phase or Section Number:
Owner� Address: Phone #:
Contractor: Address: �\ Phone #:
Description of Work to be Done Class of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floor
Second Floor
NOTICE
Garage t
Other
3 3zr7 51
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 of the performance of construction.
Signature of Con actor or Authorized Agent Print Name
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
Value of Work
to be Performed " \
A FOR OFFICE USE ONLY
O.M.B. NO. 3067-00n
ELEVATION CERTIFICATE Gpi*M%31,1996
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 INS form con be found on the following pages.
SECTION A PROPERTY INFORMATION 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 NUMBER
934 I_e-4TnV3 T�oak\1 s;.
COMPANY NAIL NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, ate.)
Lot- col 11 'e>Loc.IK A , %11uAc-FE AT c=T'ot4W0o10 cAZEK
CITY STATE ZIP CODE
Tk
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
S. FIRM ZONE
B. BASE FLOOD Et EyATtPN , .
(In AO Zones, use dep I480
'70
ooto
'�
FlFIM,,1NDEX
AM 15°
1
iE
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): '' NGVD '29 I 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 SRO, indicate
the community's BFE: I I ! I I I .LJ feet NGVD (or other FIRM) datum—slab 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 8 that best
describes the subject building's reference level
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 elevition
ofi I 4 it I(11 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 11 U feet NGVD (or other FIRM datum—see Section B. Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference !evel from the selected diagram is L I I .LJ feet above ❑ or
below'L_ (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 ' 1.I I 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: 11 the elevation datum used In measuring the elevations is different than that used on
the FIRM (see Section B, Item 71, 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: E Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: ❑ actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid It 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: 1 t 141,110 I . l .feet NGVD (or other FIRM datum -flee
Section 8, 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 to the community's floodplain rnoanagemerit ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: 1 ' I I LJ feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement ___
- - 4„ nne%nn" Ie enmrv,IeeF aFVFRSE Sll>E Fdt COMIMJAIION
4 \ `
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, cr 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 9FE),V1-V30,VE, and V (with 9FE) Is required.
Community offlcials who nre nuthorized by local Inw or ordinar+.ce to provide floodplain mnnngernenl Information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community Issued 8FE), a building official, a property owner, or an
owner's representative may also sign the certification.
deference level diagrams e, 7 and 8 - Dlstingulshing Features -If the certlller Is unable to certify to breakawayinon-breakaway well,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Featur9(9), 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 8 and C on this certificate represents my best efforts to Interpret the data table.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sectio
OF
CERTIFIER'S NAME LICENSE NUMBER (or AMIz Seal)t
GLENtJ W . F'��LL�(2 NN W. MILLER
TITLE COMPANY NAME ,r e .
Gto O &� S o jU ,( tJ r\1 4223
ADDRESS CITY �..+ ZIP
tsm GkN% u -we Q1.ING N sue 03
SIGNATURE n DATE PHONLNJ
E n
Copies should be mad* of this Certificate tot: 1) comtnunity offlelal, 2) IngurAnea agent/corrtpany, And 9) building ownbt.
COMMENTS: Mp'X- = 9-M 1"VI - ELSV. _ 4%3.S0
ON Wrnr ONPXI!S.
sus BASEMENT now. oa COLUMN!
A v A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFEnENCE BABE l!V!L
REFERENCE
LEVEL FLOOD
ELEVATION
BASE
BASE .:`:>,'•:::. ADJACENT:°;.'.: REFERENCE
FLOOD
ELFLOWN
ORALE .'3 LEVEL
ELEVATION nEFERENCE ADJACENT
LEVEL CRAGE
�r
•'i'):): t.<<:'.'i•'.4:•.::: till };�;•.
,.
'•jl[:' "i'%
'!A `.
.,..j:}i. y.;
The diagrams above illustrate the points at which the elevations should be measured in A Zone's and V Zones.
Elevations for all A Zones should be measured at fhb top of the refAtbncd Ibvbl hoot.
Elevations for all V Zones should be measured at the bottom of the lowest horitonial structural member.
10.$2'
�j 468.7
TYPE
�E
DRAIN
468.7
6' FENCE
,�•X,z CITY OF COPPELL
REVIEWED
r iproval of the P166and specifications shall
construed to mean construction in direct ea
h the City of Conoell Ruildino codes and Zol
84 P
� fiP ATOS LO
N HOUSE: 2362
14'-9" FLATW00T: 9255
w COVERAGE: 34.SX
,it POW BOUD
SMWY RBQIEM
�PAD ESM T TRANSFORMER
IF
a
469.6
F.E.M.A. LETTER
� hiIN�IMi1IK ff.
cur TC 469.4
TC 459.4 LAYTON D1:D.....1VE
THE TOP OF SLAB MUST BE
SET A MINIMUM OF 2-2xti'S
ABOVE THE HIGHEST GRADE
ELEVATION OF THE BUILDING PAD. REV FLIPPED PLAN FROM N 84 A. 07-26-96' KR
'1 do herebycertify that this drawing date: 07-09-96
or pion and related specifications David WeekleT Homes
meat o� local code reauireme it ono 1300 Post Oak BMT., suite 1000 H"5W. Tejo$ lose 713 63-0600 KR project: 303
are in ubatontiof cenferMity with V.1. i �
address: 540 LAYTON DRIVE job; 0073
subdiv: COTTONWOOD plan: S 84 A FLATWORK
FENCE
lot: 61 blk: A sect: 6 scale:1 20' SOD