FEMA-EC931227��Z
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The City With A Beautiful Future BUILDING PERMIT APPLICATION
Building Inspections Division
,q Print or Type in a Clear, Legible Manner
Job Address: 4 4 t PE 5 BL-E2� �—K Date:
[ 2 /0 1q3
Lot: j Block: A Subdivision: E A-C-iLE Po / A,/ T Phase or Section Number:
Owner: +J, , ,,_M �j _l I CM C S Address: j q b b g AfeP- l ti�-1M i �l Phone #:
3 93
Contractor: 0-v & Address: 6 Phone #:
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Description of Work to be Done Class of Work: �Iew ❑Addition ❑ Alteration
❑ Repair ❑Demolition
Area of Building in Square Feet
/
First Floor 23 ZO Garage '( Value of Work
to be Performed
Second Floor \ Other � Lo ---3 ^� C�
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee:
Receipt Number. �P .
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 or the performance of construction.
Zoning bistrict:
Occupancy Classification:
Approved By:
Date: �� �"
Comments:
—S ature of Contractor or Authorized Agent Print Name
,
Electrical Contractor Plumbing Contractor Mechanical Contractor
BIR • 1 (2192)
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ELEVATION CERTIFICATE17,;9973
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD WSURANCE PROGRAM
ATTENTION: Use of On certificate does not provide a waiver of tM flood insurance purame requirement. This form is used only to
Provide elevation information necessary to ensure compliance with applicable cmmunay floodplain management wftmw.%to
determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (COMA or IAMR).
Insfwcttons for completing this form can be found on the foflowhV pages.
SECTION A PROPERTY INFORMATION FOR INSURANcf: COMPAW USE
$AWNW6 NAME POIJGYNIIAIBER
STREET ADORES$ (=A
L. UrdL S.wa andw. Bk1p NWVWW) P.O. ROUTt AN(► BQ6 COMPANY NAIG NUMBER
1 e-
OTHER DESCRIPTION (Lit and Block N -64W&, alt.) /
CAY 4TATE ZIP C=
SECTION 8 FLOOD INSURANCE RATE YAP (FIRM) INFORMATION
Provide the following from tM proper FIRM (See Instructions):
t. GDMMUNITY NW{BER 2 PANEL NUMBER
3 -SUFFIX 4. DATE OF FIRM INDEX S FW1/ ZONE G BASE FIAOD ELEVATION
pnA02aw...wdrggj
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE); 0 NGVD a 0 00 (describe on back)
8. For Zones A or V. where no WE is provided on the FIRM. and tM community has established a SFE for this building site. indicate
the community's SFE: l l l l l l . U feet NGVD (or otiler FIRM datum -see Section B. item 7)•
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions. 94 010 the diagram number from tine diagrams found on Pages 5 and 6 that best
describes uw subject building's reference level ._L - .
2(a). FIRM Zones At -A30. AE. AH. and A (with BFE). The top of the reference level floor from the selected diagram los at an elevation
otj I JX1,471.12jest NGVD (or o9w FIRM daUr,,sse Section B. Item 4
(b). FIRM Zones V1 -V30. VE. and V (with BFE). The bottom of the lowest horizontal structural member of lite reference level from
the selerxed diagram, is at an elevation of 1 1 1 1 1 I.LJ feet NGVD (or outer FIRM daw"es Section B. !teem 4
(c). FIRM Zone A (without SFE). The floor used as the reference level from the selected diagram is L.LJ.LJ feet above 0 or
below 0 (d" one) iM highest grade adjacent to tM building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is L1J .LJ feet above 0 or below.0 (cMck
one) the hiohest grade adjac«u to the bullding. if no flood depth number is available. Is the buudinp's lowest door (reference
level) elevated In accordance with the community's floodplain management ordinance? ❑ Yet: ❑ No 0 Unknown •
3. Indicate Ilia elevation datum system used In determining the above reference level elevations: 0 NGVD -4 Q Outer (describe
under Comments on Page 2). (NOTE b Me elevation datum used In measuring Me slevaUaw is diterent Man that used an
Me FIRM (sea Section a Item ;I then convert Me elevations to Me d3"n system used on Me RRM and show Me Wnwrslfan
aquatba under Comments on Pape 2)
4. Elevation reference mark used appears on FIRM. 0 Yes 0 NO (See InOuctions on Page 4)
5. The reference level elevation is based on: El - actual =wuction 0 construcdm drawings
(NOTE (Ilse of oonsbu"ba drawkW Its only vaW a Me building does not yet have Me re/erence level Boor In place. M wlnictn
Case Mus Certuucate wifl only be valid for Me building during Me Course of oonntruabm A post-Cf>ruuuctlorr Elevation Cea7lBca a
wig be required once con swctlonn is complete.)
6. The elevation offt lowest grade Immediately adjacent to the building Is: 1114141?1.'VJ feet NGVD (or outer FIRM datum -see
Section B. item 7).
SECTION D COMMUNITY INFORMATION
1. U uta Community official responsible for verifying building elevations apectrhe3 0= 94 referents level indicated in Soma C. item 1
a not tM'lowest floor' as defined in tM commun tys floodplain management ordinance. uta elevation of IN buildiro -lowest
floor as defined by tM ordinance Is: I I I I I I .LJ feet NGVD (or other FIRM datum -see Section B. Item 7).
2. Date of the start of construction or substantial Improvement
iEltflf► F«m a1,31� MAr 90 REPLACES ALL PREVWUS EDITIONS SEE REVERSE SIDE FOR CANTO& ATION
SECTION E CERTIFICATION
This certification Is to be signed by a land surveyor. engltew. or arctiltect who Is authorized by state or local law to certify elevation
Information when the a"vation information for Zones Al -A30. AE. AH. A (with 8FE).V1N3f).VE. and V (with BFE) Is required.
ComrruuWty officials who are authorised by local law or ordnance to provide floodplain management Informatim may a" sign the
ceridication>. In the case of Zones AO and A (wommA a FEMA or comnuu y issued SFE). a building official, a property owner. or an
owners representative may also sign the certification. ,
Reference level diagrams 6.7 and 8 - Dlstinguishing Features -If tM ceRifler Is unable to certify to breakaway/non-breakaway wall.
enclosure size. location of servicing equipment, area use, wall coanirvss. or urdrished area Feature(s). thea list tM Feature(s) not
utoiuded in the Certification under Continents below. The diagram number. Section C. Item 1. must still be entered.
I certify Mat Me intomnaticn in Sections B and C on MIs cetiBcate represents my bast efforts >b interpret Me data ava//able.
/understand Mat any false statement may be puNsllable by Bne or 8rtprisorurlernt under f8 (ICS Code. Section 1G01. .
CEmiTIF1ER'S NAME LICENSE NUMBER (a Affix Seat)
rr lowed 462 7?
TITLE CXWPANY NAME
r � ze'a' - r 'Z /T o'We l '04
— clay
WE
STATE 2IP
C%** should be madKof this Certificate for: 1) community official. 2) Insurance agenticompany. and 3) building owner.
SURVEY PLAT
LOT 11, BLOCK A, OF EAGLE POINT VILLAGE AT RIVERCHASE, AN
ADDITION TO THE CITY OF COPPELL, DALLAS COUNTY, TEXAS.
LOT 12
0
0
N
8.0'
20' BUILDING LINE
n n•
LOT > I
BLK. A
FORMBOARD
SURVEY
8.0'
0
0
8.01 LOT 10
10' UTILITY EShf'T
T-
1 90 00'0M
66.00S 87 47' 00" E
REFERENCE BEARING
1441 PEBBLE CREEK DRIVE
I hereby certify that on the�day of — 19`F2 this survey was made on the ground as per the field notes shown on this survey
and is true, correct, and accurate as to the dimensions of the subject property and rise, location and type of buildings and improvements therson,
if any. The survey shows all easements and visible easements of which I have knowledge or have been advised affecting the subject properly.
There are no encroachments• conflicts, or protrusions visible on the ground other than those showm
l�p of
Date . �?�r�. ��. /13 �c. �" v� JOB # .
HARRY J. ROIIELL
CF No 45x7
0 LEGEND
1/2" Steel / Iron Rod Found O
1/2" Steel / Iron Rod Set
Property Line
I•ood Fence ------- —
Chain Link / hire Fence x—x—x—x—x
!)vcnccad Electric — E — E— E —
�h
Scale: I"
Ell
HARRY
R0 WELL
& Associates, INC.
Surveying & Engineering
1301 Elm Street Ste. 201
Carrollton, Texas 75006