FEMA-EC960717 (2)C r�
BUILDING PERMIT APPLICATION
R. ). I Print or Type in a Clear, Legible Manner
r_
80606
Job Address:3,23 A1491 j, A� E
Date: -�
G
Lot: Block: Subdivision: (—/0/)-7t�5 Phase or Section Number:
Owner 1
?- Address: ) � Phone #:
� % <--C:�/i�/;� �
Contractor: ,-,, Address: , j�
_„1-c.��' � phone #: 01
Description of Work to be Done Class of Work: New ❑ Addition
❑ Alteration ❑ Repair p El Demolition
G +I
wo Z
Area of Building in Square Feet
First Floor `� & / Garage 6161
Second Floor r� Other / ? �c
Value of Work
to be Performed
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee:
Li
'-- Receipt Number: ?
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
Zoning District:
Occupancy Classification:
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
Approved By:
Dale:
Comments:
00
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.
WA R29Signature
of Contractor or Authorized Agent Print Name
�"f�'u� ���l�r✓rte rk-J�'eC�i�r4,��
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
t UYATION CERTIFICATE o.M.a. ay 6eon
• Expires hfMay 3 t,, 1991
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 Lotter 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 iNSURAMMCOMPANY USE
BUILDING OWNERS NAME
STREET ADDRESS ` np Apt Unit, Suite and(or Bldg. NumWr) OR P.O. ROUTE AND BOX NUMBER
op ;OTHER DES IPTION (Lot and
POLICY NUMeEq
COMPANY NAI; NUMBER
CITY T` STATE ZIP CODE
SECTION 0 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY, NUMBER
2. PANEL NUMSER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZON#
6. BASE FLOOD ELEVATION
7. Indicate the elevation datum system used on the FIRM for Ba4e Flood Elevations (BFE): ❑NGVD'29 ❑Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and tris community has established a SFE for this building site, indicate
the community's BFE: I L��J.(J 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 diagrat(iis found on Pages 5 and 6 that best
describes the subject building's reference level
2(a). FIRM Zones At -A30, AE, AH, and A (with BFE). The top of the refergrtce level floor)rom the selected diagram is at an elevation
of !_ 7aj, feet NGVD (or other FIRM datum -see Section B, Item 7).
(b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of Iha lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of Ll ' 1 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 L_LJ.L feet above D. or
below, {check one) the highest grape adjacent to the building.
(d), FIRM Zone AO. The floor used as the reference level from the selected diagram is 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 E) No ❑ Unknown
3. indicate the e'evation 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 S. Item 71, then convert the elevations to the datum system used on the FIRM and show the conversion
equation unser Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: X Yes El No (See Instructions on Page 4)
5. Tne reference level elevation is based on:2 actual construction � construction drawings
NO TE: Use of construction drawings Is only valid if the ouildina does not yet have the reference level floor in place, in which
case this cerWicafe will only be valid for the building during the course of construction. A pest -construction Elevation Certrlicate
will De required once construction is complete.)
6. =he Plevat on of the lowest grade immediately adjacent to the building is: l`716 8', feet NGVD (or other FIRM datum -see
Seztlon 9. item 7).
SECTION D COMMUNITY INFOSMATION
It the community official responsible for verifying bunoeng elevations specities that the reference level indicated in Section C. Item 1
's rot the "lowest floor" as defined in the communsty'S fl000plairt management ordinance, the elevation of the building's 'lowest
roar' as defined by the ordinance is: I I I I I feet NGVD (or other FIRM datum -see Section B. Item 7).
2. L�a:e of the start of construction or substantial Improvement
FE AAA F0im 81.31a MAV 90 REPLACES ALL PREVIOUS EDOION$ SEE REvtRSE SIDE FOR CONTINUATION
` SECTION E CERTIFIGAT1p1 '
This certification is to be signed by a (and surveyor, engineer -or arct,rtect who is authorized by state or IOCAJ law to cell,ly ucav it.
information when the elevation information for Zones Al -A30, AE, AH. A (with 8FE),V1-V30,VE, and V (with 8FE) is requiro j.
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 is mW SFE), a building offidritlE A property owrwr, 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-brepkaway
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list theboat ,
included in the certification under Comments below. The diagram number, Section C, item 1, must sWI be entered. . .,•F
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data av 'IAc 11
I understand that any false statement may be punishable by fine or 47pprisonment under 18 U.S. Cow, Section f..�RRY.� � ..•��
••• ••.•oo. a.c S.N.• •••
CERTtfIER'S ME LICENSE NUMBER (or Affix Sial) �� P
T ITIS COMPANY
,r J PLS c i �rrr..�
CITY L -el
dud
'
DATE �ft"E
mads of this Certificate for: 1) community official, 2) insurepce agenllcompany, and 3) building JwE+.,r,
COMMENTS:
ON Wml au PIL".
SLAB SASEMEF.0 HERS, on COLLUANS
A V A A Y .
ZONES zOhES - ZONES ZONES ZONES ++
a~�' IEE/111EMCE .�,
-••ter =� ` Irr ``tj, l
e �sE
qp ACJe:EM I. REIEt+ENLE \. ��1 lltK7G
E ,.•.:,n hE!"•r.e'.I.• Iw�ntt,r af:.ECi t[. E:
•Fvfi 01MDE ��11
hlI 4
• , `� ;til,, ,,t .' ti , q
�' , 111 ��y AA✓.GEMT ' �,
rr 6 "oE
Tr a diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zorler
t
E'-rati:ws for all A Zones should be measured at, the top of the relerE;nce level floor.
E :;vat wr+s Eor all J Zonas should 4e measured at the bottom of the lowest horizontal structural member.
?Pgu 2
85.00'
,
CITY OF COPPEL
REVIEWED
GATE
,t,ppr ��:al cf the ns and specificatio s shall not
the construed to mean construction in d�
vvith the City of .CDppell Building codes
Ordinances.
I PLANS ARE REVIEWED FOR
APPROVAL OF SINGLE
FAi'rl� %" SES 'FENCE ONLY.
OTHEIZ PEPICTIONS OR
PATIOCALL-C-UTS ON PLOT PLAN
HAVE NOT BEEN REVIEWED
AND ARE NOT APPROVED•
es• -o•
t O'
b'
RESIDENCE IJ�1
t0 "IN
1 GAR GE
CONC.
DRIVE {
I
iz-a
( ) STgEET
FORM BOARD I
SURVEY REQUIRED
i
i
30' B.L.
o 8a8
• CO
NC. "
3R WALK
1OTI'LIL. EASMT.
0'6 _
MARTEL LANE
- — — — J
NORTH
F.E.M.A. LETTER UIP
MINIMUM f f.
SITE PLAN
SCALE, I' - 20'-0'
LOT 15, BLOCK E
COPPERSTONE
DALLAS COUNTY
COPPELL, TEXAS
14
i • SURVEY P LAT
BARRY S. RHODES Registered Professional Land Surveyor (214) 475 - 8940
This is to certify that I have, this data, made a careful and accurate survey on theyound of property located
at No. MArerZL LAME , in the citltbf _ C���F�L Texas
Lot No. /$ , Block No. City Block No.
of eO,-An addition to the City of CoP -1/, D4 LAT (6OWY
Texas, according to the recorded in Volume at page
of the Map.Rscords of fD4L_Gk_i" COUNTY, TEXAS.
ARTEL
The plat hereon is true, correct, and accurate representation of the property as dvtsrminsd by
survey, the lines and dimensions of said property being as indicated by the plat: the size, location, OF
and type of buildings and improvements are as shown, all improvements being within the boun•pi•.........
daries of the property, set back from property lines the distance indicated, and that the distance y't.•' tST Ne.�
from the nearest intersecting street, or road, is as shown on said plat. Q
THERE ARE NO ENCROACHMENTS, CONFLICTS, OR PROTRUSIONS. •••ti• ••• • ....t...
scale:�i00 THIS SURVEY WAS PERFORMED EXCLUSIVELY FO ..B .�R sDM
Data: -28- 96 a4letIC)" �-1c mc_� be.
F. No.: USE OF THIS SURVEY FOR ANY OTHER PURPOSE
Job No.:
55406 OR OTHER PARTIES SHALL BE AT -HEIR RISK
AND UNDERSIGNED IS NOT RESPONSIBLE TO OTHERS
Checked by: FOR ANY LOSS RESULTING THEREFROM.
TELEDYNE ►OST NOW