FEMA-EC020220BUILDING PERMIT APPLICATION
r%� Print or Type in a Clear, Legible Manner W m 'Q('41 L 69,
Job Address: 7Dz M,9DISO1l
Date: 'J—arii a1 /8, 0'Z
Lot: H Block: —V Subdivision: Main p ll*Z P r'K,
Phase or Section Number:
Owner S7 -"67r' C(!.5?OM P0/YIF-5 Address:/46O.S. s�emmOnS, ,5 Phone #: 97'2.393-22078
Contractor: Address:
71
Phone #:
Description of Work to be Done Class of Work: New ❑ Addition
❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floor 21716 Garage 8§1Z
Value of Work o0
to be Performed
Second Floor 96-6 Other
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee:'
Receipt Number: ,(#C3f"( 3p
Zoning District:
Occupancy Classification:
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
Approved By:
Date:
d2,
at any time after work is commenced.
1 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
Comments:
give autho by to violate or cancel the provisions of any other federal, state or local law
regulati onstruction of a performance of construction.
-R ' 1
nature of Co &actor or Authorized Agent Print Name
�'-A e +ey l t}CI W hl eAewnL1-15 N/�4
Electrical Contractor Plumbing Contractor j Mechanical Contractor
FPMC • 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
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1329'
11.49'
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Herzog Residence
702 Madison Drive
Lot 19 / Block D
Magnolia Park - Coppppell, Texas
Street Custom homes
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1329'
11.49'
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Herzog Residence
702 Madison Drive
Lot 19 / Block D
Magnolia Park - Coppppell, Texas
Street Custom homes
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4' CONCFMTE SID WALK
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FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
- NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2Q02,
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1- 7.
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.I Company NAIC Number I
702 MADISON STREET
CITY STATE ZIP CODE
COPPELL TX 75019
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 19 BLOCK D OF MAGNOLIA PARK ADDN.
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type):
( ##' - AW - ##.W or ##.#lull#°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
BC1�COMNUNITY NAM` & COMMUNITY NUMBER - I DALLAS NAME I TEXAS TE
OPPE
B4. MAP AND PANEL
B5. SUFFIXB7.
FIRM PANEL
Datum _ ConversiarlCornments
B9. BASE FLOOD ELEVATION(S)
NUMBER
I
B6. FIRM INDEX BATE
EFFECTN ET EVISED DATE
B8. FLOOD ZONE(S)
Pie A0, use deplh of flooding)
155
J
08-23-01
❑ b) Top of next higher door
X
WA
B10. Indicate the source of the Base Float Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Desaibe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ® Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1(Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. ff no diagram
accurately represents the building, provide a sketch or photograph.)
C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/Al -A30, AR/AH, AR/AO
Complete Items C3. -a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum _ ConversiarlCornments
Elevation reference mark used Does the elevation mference mark used appear on the FIRM? ❑ Yes ® No
❑ a) Top of bottom flax (inducing basernent or enclosure) 467.. 41 ft(m)
ti OF T
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G2WSTB.
❑ b) Top of next higher door
_ —ft.(m)
� F' .�•
❑ c) Bottom of lowest horizontal structural member (V zones only)
_. —ft(m)
o
....3.....«..^.......... .
❑ d) Attad)ed garage (top of slab)
— 7 ft.(m)
s
HARRY J. ROWELL
El e) Lowest elevation of machinery and/or equipment
w
•N. NA N.......N.«t}.
4597
servicing the building (Describe in a Comments area)
_. —ft.(m)
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❑ f) Lowest adjacent (finished) grade (LAG)
_• —ft(m)
d .2
SIJR
❑ g) Highest a4acent (finished) grade (HAG)
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjaoent grade
❑ i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that anv false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
CERTIFIERS NAME HARRY ROWELL LICENSE NUMBER 4597
TITLE SURVEYOR COMPANY NAME HARRY ROWELL COMPANY
ADDRESS CITY STATE ZIP CODE
1301 ELM STREET STE. 20> CARROLLTON TX 75006
SIGNATURE DATE TELEPHONE
02-20-02 (972) 242-5679
FEMA Form 81-31, JUL OV SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
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H RF SURVEY PLAT H R
LOT 19 BLOCK D OF MAGNOLIA PARK AN ADDITION TO THE CITY OF COPPELL DALLAS COUNTY, TEXAS RECORDED IN VOL.
98145, PG. 506, OF THE PLAT RECORDS OF DALLAS COUNTY, TEXAS.
LOT 20
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81 "42'3"
8.5
8.4
COMMON AREA & DRAINAGE ESMT
77.49
/ 97°39'42" W
LOT 19 OD
13.29
83°13'50"
N
5 UT ESMT
11.•
Ft = 315' —
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LOT 18
98° 17'57"
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oo 702 MADISON STREETol
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oo I hereby certify that on the 20TH day of FEB. , 20 02 , this survey was made on the ground and this survey plat has been prepared as per the field oo
oo notes thereby produced, and it property represents the facts as found on the ground. This survey plat has been prepared in accordance with, and in
oo substantial compliance with , all rules and regulations promulgated by the Texas Board of Professional Land Surveying. Unless otherwise noted, the ol
oo surveyor has relied solely on the record data provided In the title commitment for the determination of the boundaries of the land parcel surveyed and for ol
ol
oo any easements of record which may be shown or addressed on the survey. The survey shows visble easements, encroachments, conflicts, or oo
oo protrusions apparent on the ground. ol
Date: FEBRUARY 21, 2002 �'S��va`�o, JOB # : 02-1230 000
GF No. HARRY J. R 0 W 9 LL
4597
LEGEND 0 Scale: 11"= 20r4 HARRY
1/2" Steel / Iron Rod Found O
1/2' Steel / Iron Rod Set w/ Red Cap '4597' • ROWEL L
Property Line By: � 8 Associates, INC.
Wood Fence — —
Surveying &Engineering
Chain Link / Wire Fence X—X—X—X—X 1301 Elm Street Ste. 201
Overhead Electric — E— E— E— arrollton, Texas 75006 (972) 242-5679