FEMA-EC001026Tire City W5hh Beauhlul Future
BUILDING PERMIT APPLICATION
Print or TVDe in a Clear, Leqible Manner /I) M ;4�/nLj
Job Address: 123 All Edes TACe
Date: S t //y O0
Lot: 5 Block: S Subdivision: MpGl✓OLtf! PAkX
Phase or Section Number:
Owner 56rEEt &AZA4 4)MES Address: /bfoO S. S femntonA LeuJ S ' l
j jw Phone #: 972 -g93-,7078
Contractor: Address:
Phone #:
Description of Work to be Done Class of Work: New ❑ Addition
single_ 4rN((4 de shed
❑ Alteration ❑ Repair ❑ Demolition
Area of Building in Square Feet
First Floor -31.51 Garage '70'Y Value of Work
to be Performed SOZ 10.00
Second Floor) -39Q Other
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
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
give authoto violate or c cel the provisions of any other federal, state or local law
regulatin c stmction of the rfornance of construction.
xobi. Ailep,
Permit Fee:,/'YA5, ---
Receipt dumber:
Zoning Dlstri[`
L,5
Occupancy ClaSSIfICaticin: .kms i
!r j�i
Approved By:
Cate: ,�"3
L/'
Comments: ir
Si azure of Contractor or Authorized Agent Print Name
Ft SH E/Ecrn is �e / n
Electrical Contractor Plumbing Contractor Mechanical Contraftor
FPMC - 1 4/901 lad 0�
•
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
BUILDING
CITY
USE (e.g.;
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
O:M.B. No. 3067-0077
Expires July 31, 2002
Important: Read the instructions on pa es 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
and Block Numbers, Tax
and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
Company NAIC Number
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: I_I GPS (Type):
( ##° - ##'- ##.##" or ##.#A###°) IJ NAD 1927 1 ✓TNAD 1983 1_I USGS Quad Map I_I Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
NFIP COMMUNITY NAME &
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
_
. L7ft.(m)
DATE
EFFECTIVE/REVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
CSO /O
e -c-
u
_ fl.(m)
=
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
1-1 FIS Profile I_✓fIRM 1-1 Community Determined I_I Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: I_I NGVO 1929 1-1 NAVD 1988 1_1 Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes 1_1 No
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: I_IConstruction Drawings' IL -I iuilding Under Construction` I-1Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number / (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7. If 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, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3a-i 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 Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appe
❑ a) Top of bottom floor (including basement or enclosure) BGG
ft (m)
v
❑ b) Top of next higher floor
ft.(m)
0
❑ c) Bottom of lowest horizontal structural member (V zones only) 4 6!c
_
. L7ft.(m)
❑ d) Attached garage (top of slab)
_ fl.(m)
E a
❑ e) Lowest elevation of machinery and/or equipmentLD
u
servicing the building
_ fl.(m)
=
❑ f) Lowest adjacent grade (LAG)
ft.(m)
z' y
❑ g) Highest adjacent grade (HAG)
_
_ ft -(m)
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
❑ i) Total area of all permanent openings (flood vents) in C3h 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 any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
FFMA Fnrm Al-Z'I At Ir: W CFF RF\/FRCP CIr1F FOR r.ONTINI IATION RFPI Ar.FC At 1 PRFVIr1I IR Fr)ITIONC
SURVEY
� PLATO R
LOT 5, BLOCK B, OF MAGNOLIA PARK, AN ADDITION TO THE CITY OF COPPELL,
DALLAS COUNTY, TEXAS, RECORDED IN VOLUME 98145, PACE 506.
,aMIN�NelelpeNly VIII
LOT 5
BLK. B
-
6>„
ter
S.
� BST
FORMBOARD
SURVEY
F•f. 6GE7! -X"./7
2
ss -
/L
\
1/2"IRE
( R=50.00') I/2"IRA
123 NA T CHE S TRACE
W LOT 4
Oti bei n Y
c
0 ebt
I hereby vertify that en the7�da
y o f i_Ly., Lpxj this survey e g mad. rn the ground and tA{e rurvey pied in Even prepared it a per the Jum
notes thereby Pniance and it properly and
represents othen fate a found of the Around Thio rurvry Ptat hL been prepared U aoeordh r .. noted, and h
rubetanr h eorelied ee vdto . allhe ruler and a provided n the (i . 6y fM Tesa Board of Pnf ion o l Land Surveying. the l d pwo.e ethe
any .. ha of eo{e{y on h rce be data provided {n the fifth eommiy. Th for the determination of t. bnto, G. of the {and nfiw or and for
"..aemenb of nton Me ,r may Eh A. or addrcseed on fM survey. TM rurvhY sAowe v4EM eaemmte, encraaAmente, oonfticte, or
pntnu{oru apparent on fh. grauM
Date : OCTOBER 26, 2000 �g of r�
JOB #
CF No. _
® LEGEND 0 Seale: 1
1j2.. Steel / Iran Rod Found O
1/2" Steel / Iran Rod Set
Property Line
Load Fence
Chain Link / dire Fence x—x—x—x—x
Overhead Electric E—E—E—
�fMT e�'ee
RRY ELL
sUR�°4
HARK Y
ROWELL
& Associates, INC.
Surveying & Engineeri
1301 Elm. Street Ste. 201
Carrsl{ton Tempe 75006 (892)242-66