FEMA-EC990721® W
Fautiful/(Y)
The City With A future BUILDING PERMIT APPLICATI.ON.
y
Print or Type in a Clear, Legible Manner
Job Address: h ,CX I ^/6 TO N
Date: '�u n 9,
Lot: AV Block: Subdivision: fn4 ft;1 � A
Od, -SK 1 NG S Phase or Section Number:
Owner S� ISP p �'►►►.t k-1) tP.S Address: /6&0 S . 5jern nvj)n_S awl 5✓! ��� Phone #: f7,72. 3 � Q /
C .0 S t�
ie
Contractor: M e Address:
Phone #:
Desgpl4ition of Work to be DoneClass of Work: New ❑ Addition ❑ Alteration ❑ Repair p ❑Demolition
51 A16 L ie—rL
nils V DrrAP14e)
of Building in Square Feet
,
First Floor Garage 7/4-
Value of Work
to be `Performed
Second Floor Other
{
40
GRAY AREA FOR OFFICE USE ONLY r
NOTICE
This permit becomes null and void if work or construction authorized is not commenced ,•"I
for 180 days ZC Occupancy �iiaal
within 180 days, or construction on work is suspended or abandoned a period of b
a f
at any time after work is commenced. `
Date:
know
I hereby certify that I have read and examined this application and the same to be trues"'
complied with whether specified herein or not. The granting of a permit does no will
and correct. All provisions of laws and ordinances governing this type of -wo will beFIX
to
give authority to violate or cancel the provisions of any other federal, state, or local law
re ulati construction of a rfoimance of construction.
1
Signature of Cont actor or Authorized Agent Print Name 4.t'� ='
°?7
i
s
k T s NP
Plumbing
Electrical Contractor g Contractor Mechanical
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
ELEVATION CERTIFICATE
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.
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I
BUILDING OWNER'S NAME
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
POLICY NUMBER
COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
4077 ,Z 64,0 G�e B S u rnrn i T A9 77 T.s/.E' �'�� Z4&-- S O
CITY STATE ZIP CODE
CO P/o.cfL L ._. TX
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
(in AO Zones, we depth)
4.
1 kc'
I —
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ilIrvGVD'29 L1 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), 1
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
-00'« of � .� 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 i l l l l .0 feet NGVD (or other FIRM datum—see Section B, Item 7).
�i (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected dia ram is W . U feet above ❑ or
below ❑ (check one) the highest grade adjacent to the building.1V07'E - e�',6609.9 W,15 T*&e."V N 7—
roye ,t oe l ,,ev T :G•�'✓�G of f'o.eryi daq�2,�tS
i� (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W . U feet above ❑ or below ❑ (check
a, one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
Qlevel) 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 71, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
Q 4. Elevation reference mark used appears on FIRM: ❑ Yes Ngo (See Instructions on Page 4)
�I5. The reference level elevation is based on: 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 Cetfificate
will be required once construction is complete.)
6. The elevation of the lowest grade immediately adjacent to the building is: i l l l l l .0 feet NGVD (or other FIRM datum -see
Section B, Item 7).
This certification is to be signed by a land surveyor, engineer, or architect who Is,. authorized by state or local law to jWtify elevation
information when the elevation information for Zones Al—A30, AE, AH, A (with 13FE),Vi—V30,VE, and V (with BFEis required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, milky 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.
I certify that the information in Sections B 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. Gode, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER or Affix Seal) g`�:" �' "� *p
lvi9gReK /QOGt� L[ -r
TITLE COMPANY NAME/ HARRY J. R0r'CLL
cl,eU Q RO4/Cj11C (foe ... ..... .
ADDRESS CITY ••STA ZIP
/ 4 •�` S7AO T
SIGNATURE 7^Z DATE Q
d79 I(
Copies should be made cehis Certificate for: 1) community official, 2) Insurance agent/company, and 3) Wilding owner.
COMMENTS: A6 !%? S4)_6Z,4k6— e6e77
/YO .4e 7-1y, c l a5- Dom'-ED/i?a/1J� SD/V Oe? a �� G✓•�� ��'
►/IIII/I/////IIII//////I/I/I I////IIII/I///III//II/I/IIIISURVEY PLAT
LOT 24 BLOCK B OF SUMMIT AT THE SPRINGS AN ADDITION TO THE CITY OF COPPELL
DALLAS COUNTY, TEXAS REC. IN VOL. 98162, PG. 27, D.R.D.C.T.
767 LEXINGTON AVENUE
3T 25
I hereby certify that on the 21 STday of JUL. 19-Y-9— this survey was made on the ground and this survey plat hoe been ppreP.- as pee the field
notes thereby produced, and it properly represents the facto as foand on the ground. This survey plot has been prepared in aocordance , and in
substantial oomplienee with -the
rules and regulations promulgated by the Texas Hoard of Professional Land Surveying. Unless otherwise oted, the
snneyor has relied solely on the record data provided in the title commitment for the determination of the boundaries of the land parcel trveyed and for
any easements of record which may be shown or addressed on the survey. The survey shown viable easements, encroachments, conflicte,4r
protrusions apparent on the ground.
Date : AUGUST 03, 1999
19 LEGEND 0
1/2" Steel / Iron Rod Found O
1/2" Steel / Iron Rod Set
Property Line
Wood Fence -------•—
Chain Link / Wire Fence x—x—x—x—x
Overhead Electric E— E— E-
4597Scale: V,•
►iiiiiiiiiiiiiili�//III//II����� ���
JOB # : 99-3736
HARRY
ROWELL
& tnociates, INC.
Surveyi*g & Engineering
1301 Elm Street Ste. 201
rollton, Texas 78008 (972) 242-581