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FEMA-EC030129T H E C I T Y O F COPPELL - BUILDING PERMIT APPLICATION 164 ¢ Print or Type in a Clear, Legible Manner -77 Job Address: �' -es- C� Date: t 0 Lot: Block: Subdivision: '` �1� r i Phase or Section Number: Owner: Address: P-0 acs' k e a'`A Phone # l�a 313' 3 PC -I;)-- Contractor: (1 Address: Il Phone #: \�1�' 8 �b - 7 1 Description of Work to be Done Class of Work: anew ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition Area of Building in Square Feet First Floor S f S Garage 1 i Second Floor` 59'7 Other 4 I v 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 20 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 M be complied with whether specified herein or not. The granting of a permit does not 0 presume to give authority to violate or cancel the provisions of any other federal, state" or local law re ylatin const ton or the perfo ance of construction. t ✓qos-� Signature of Contractor or Authorized Agent Print Name M t I C t t PI mbino Contractor Mechanical Contractor Value of Work / 06 ®© to be Performed (� GRAY AREA FOR ec nca on rac or u c BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK Y ' NATIONAL FLOOD INSURANCE PROGRAM O.M.B. 3 , 00 Jul 2 Expires July 311 , 77 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages I.7. SECTION A - PROPERTY OWNER INFORMATION For Irsisanoe Company use: BUILDING OWNER'S NAME Policy Number BRENTWOOD BUILDERS BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 611 PRESTWICK COURT CITY STATE ZIP CODE COPPELL TX 75019 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 3, BLOCK A, PRESTWICK ADDITION 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): ( ##° - ## - ##.##' or ##.1 ) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE COPPELL - 480170 DALLAS TX B4. MAP AND PANEL B5. SUFFIX o a) Top of bottom floor (including basement or enclosure) 87. FIRM PANEL co B9. BASE FLOOD ELEVATION(S) NUMBER B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of flooding) 0155 J 8-23-01 8-23-01 X NIA B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): 611. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrer 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. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations – Zones Al -A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.-aA 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 NGVD 1929 Conversion/Comments Elevation reference mark used # Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (including basement or enclosure) 459. 68 ft.(m) co o b) Top of next higher floor N/A. o c) Bottom of lowest horizontal structural member (V zones only) _ft.(m) N/A. (h o d) Attached garage (top of slab) 459. 68 ft.(m) E o e) Lowest elevation of machinery and/or equipment u, cc servicing the building (Describe in a Comments area) N/A. 00 ft.(m) E co o f) Lowest adjacent (finished) grade (LAG) 458.29 ft.(m) z m o g) Highest adjacent (finished) grade (HAG) 458. 73 ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 J o 1) Total area of all permanent openings (food vents) in C3.h N/A 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. / certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understa any falsest ement may be punishable by rine or imprisonment under 18 U.S. Code, Section 1001. CE R'S NAI E/— FRT C. MYERS LICENSE NUMBER 3963 VICE - PRESIDENT NAME ANALYTICAL SURVEYS, INC. ADDRESS CITY STATE ZIP CODE 707 EASY STREET GARLAND TX 75042 SIGNATURE DATE TELEPHONE 1-29-03 972-272-0287 FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS .IMOORTANT: In these spaces, copy the corresponding information from Section A. For Insuranoe Company Use: BUILDING STREET ADDRESS (Including Apt, Unit Suite, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO. P*y Number 615 PRESTWICK COURT CITY STATE ZIP CODEI Company NAIC Number I COPPELL TX 75019 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS BUILDING IS FORMS ONLY. ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. 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.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ft.(m) _in.(c m) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community s floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3J only), and E for Zone A (without a FEMA�issued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the nest of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the kommunitys floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone A0. G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER I G5. DATE PERMIT ISSUED I G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: — _ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _. _ ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here if attachments FEMA Form 81-31, JUL 00 REPLACES ALL PREVIOUS EDITIONS FORM SURVEY BEING LOT 3, IN BLOCK A, OF PRESTWICK, AN ADDITION TO THE CITY OF COPPELL, TEXAS, ACCORDING TO THE MAP THEREOF RECORDED IN VOLUME 2001 131, PAGE 9, MAP RECORDS, DALLAS COUNTY, TEXAS. %x FND 1/2" I.R. 101'9, L,��� E CP FND 1/2" I.R. .3 AT A 1OFFSET N 20' SANT. '�. SEW. ESMT. 0 '20, Ply I.P tPN ( ( R VOL. 958, 11.4' PG. 914) tV I so 36.1' o �� of a 8.7' 2 a^ 20.6' r'i M 3. 20.0' 3 Z 4 . Z A m J.i . 0i 0_ _ L` a, It o FORMS ONLY N - CL T.O.F. = 459.68 ti M � � � H 11.3' 12.3' I 14.6' 0031: / 21.0' LO C4 O N 13.4' ri I N I 21.7' r. ai Go "o //� FND 1/2" I.R. •o, i i ("?- �� I T.C.= �� / / ' 455.55 � p0 O , i i i i i PPI p, R� p G�� FND 1/2" I.R. T.C.= 456.19 R . tib3a3• P 1 NOTES BRENTWOOD NO SEARCH OF RECORD EASEMENTS HAS BEEN BUILDERS PERFORMED ON THIS PROPERTY. (P.P.) INDICATES THAT BUILDING LINES, EASEMENTS, R.O.W.'S ETC. AS SHOWN HEREON ARE PER PLAT. Pt6 �F reg G S �••��•'••• ADDRESS 611 PRESTWICK COURT rtOBERT c. NAME NAME 8-3A • 0,3963?rte ' P.O. N0. N/A ......SCALE 1 =20' DATE 1-30-03 ROBERT C. MYERS R.P.L.S. NO. 3963 DR��N((.y�BY SLJ ROBERT 2 MYERS AnMli4#iri�l uruP s, .i�nr• 707 GARLAND, TEXAS (972) 272-6287 R.P.L.S. NO. 3963 "A PROFESSIONAL COMPANY OPERATING IN YOUR BEST INTEREST" 75042 101-1q' ,.,,•- -' r � r ' 1 O r 1 1 1 r � r r r , r � , r 1 1 1 1 1 m' , 1 1 1 1 1 m 1 � o �4 �1�v1wv� i E . n 1-1 1 -4 'I O IL -b ,-' , t ,%too Cot IIN PRE5TV41 GK GT. PLOT FLAN LOT. -5-A 611 PRESTWIGK GT. SCALE: 1"=20°-0° PRE5TW I GK A 7D 1 TI ON .JoB #2212b GOPPELL, TEXA5 DATE: IVIN02 1 1 r � 1 r r , r � , r 1 1 IL -b ,-' , t ,%too Cot IIN PRE5TV41 GK GT. PLOT FLAN LOT. -5-A 611 PRESTWIGK GT. SCALE: 1"=20°-0° PRE5TW I GK A 7D 1 TI ON .JoB #2212b GOPPELL, TEXA5 DATE: IVIN02 p11� nW I 1 11 I I I 1 ' 1 I ' -20,- P) w 1 1 �I cool, V rJ 1 yam. 1 bo 3 lv at i'R� +910K GT. >' FLOT FLAN LOT:5--A bIl PRE5TWIGK GT. SCALE. i 201-0° PRE5TWIGK AI7VITION Jos #2212b GOPPELL, TEXA5 DATE: 9/18/42 01/20/2003 08:55 972-272-8407 ANALYTICAL SURVEYS PAGE 01 FORM SURVEY BEING LOT 3, IN BLOCK A, OF PRESTWICK. AN ADDITION TO THE ITY OF VOLUME O 2 01L131,XPAGE 9. MAP RECORDS, DALLAS COUNTYAS, ACCORDING TO THE MAP THEREOF , CORDED NTEXAS. 'X FND 1/2' I.R. 1070 00' R 101 79' FND 1,(2' I.R. AT A 1 OFFSET 2 FND 1/2' T.C.= 456.19 1/2' I.R. NOTES BRENTWOOD NO SEARCH Of RECORD EASEMENTS HAS BEEN BUILDERS PERFORMED ON THIS PROPERTY. (P.P.) INDICATES THAT BUILDING LINES, EASEMENTS, Oa R.O.W.'S ETC. AS SHOWN HEREON ARE PER PLAT, y�.��sr�, j�o•.r :.... ....... ADDRESS 611 PRESTWIC COURT C' W� NAME B -3A P.O.NO. N/A suli�Ev LE DATE 1-30-03 V.LL N0. 3063 ORN. BY SLJ 06OEI1T G YTtA3707 OV 5"M Om V3- l3w R.RI.l. 00. 3063 "A f06K3301" COIMIWY 0p[RAlUlO IN YOYR 0651 WiQK37'