FEMA-EC9504067They With ABeautiful Future
BUILDINa PERMIT APPLICATION
%a, Z I Print or Type in a Clear, Legible Manner
Job Address: '" LL l L Date: 9 _
Lot: O Block:
Subdivision: ��w�� ) I ,c ( Phase or Section Number:
rC ►( �.al C
Owner:
.�.J Address: l 1 2 4 es 4'K' Phone #:
A/ �' a 1 Zo. t r '1 t„Z ' a► ��a S K % J .ZZ / }` O
Contractor: /Uj� n��� j lc A r tc. Address: O. �D / ��ooz Phone #:
Description of Work to be Done 1 Class of Work: 04ew
❑Addition ❑ Alteration ❑ Repair ❑Demolition
c w 4.� �Q. `0.w.. 1 �� r` QS � M C r► C.. '�"' vG S�a �' �✓
Area of Building in Square Feet
First Floor vZ Garage Value of Work
to be Performed ,�J � ,0 o
Second Floor � Other �—
GRAY AREA FOR OFFICE USE ONLY
NOTICE
This permit becomes null and void if work or construc don 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 comect. 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.
zllg/� , .>�.. Al dkwke . pry.
Signature of Contractor or Authorized Agent Print Name �—
.1)e„�a,.
Electrical Contractor Plumbing Contractor echanical Contractor
FPMC -1 (4/94)
PR- -4 - 9 5 TUE 1 3 0z DAY I S LANA S U R V co I NC R. 0 1
ELEVATION CERTIFICATE
PEDERAL EMERGENCY MANAGEMENT AGENCY'"s
ArtENT ON: use of this Certificate does not provide NATIONAL a veerrQof tthe INSURANCE GROGRAM
Provide elevation information nacessery to enure Compliance with a purchase "ulremgnt, This form it: used only to
determine the proper Insurance premium rate, and/or to su itable wmmunity noodpla;n mer��gQThis ordinances, ro
fns ruction$ for Compl�ing thfctt form an be W d tin ho fOf ol windment or Revision (LAMA pf LOMH)
SECTION A PROPERTY INFORMA-noN ng Pates
$UiLOING OWNq" N s . /+ PDN INSWOME COMPANY use
M u f r�t�ld `VS"'�-� py1 �,,,lO f'Y1 �S p0�1CYNVMBEFi
6 i MEET ADORM OrAgU$NV Apt.. Unk. 5uine andlpr---�
Eidp. N1rmp�r) OR P.O. ROUTE AND BOX N<JMBER COAffANY NAIL NUMpiR
OTHER DESCRI MON (La aro BkK* Numbers. iso) —
Lo+ to 81Ock .
oITYCo �____. th La ke Wood (a r%ds
G I! T X ^7 S O 19 Is E ZIP CADS
VM011wry n FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instruotions);
ff
1, C/ O/�1M��MVNrty NWgtq
41tO 1O00
3. PANEL NUMBER
O' O
I
3. SUFFIX7---F--T_
OF FIRM INOEX
FIn;M ZONt:,
tp z pljp ����Vyw,�1,,1�4N
E
1 �'�
A E(�
�r�eiM U" 0Wh)
7. indicate the e100011 datum system used on the FIRM for Base Flood Elevations BFE :NG VD '29 X�s 472.00
a. For Zones A or V, where no SFE is provided on the FIRM. and the Community has(establl'shed a OFE �istbuilding her �, j�� Q! k}
the community's 9FE; LI—LL - j , U feet NGVD (or other FIRM oatu"ee Section U. Item 7),
SECTION G WILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, Indicate the diagram number from the diagrams found on Popes 5 and 6 that best
describes the subjW building's reference level .
, 2(a). FIRM Zones Al •A30, AE. AH, and A (with SFE). The top of the reference level floor from the selected diagram is at sn elevation
of ZJ„@f feat NGVD (or other FIRM datu"ee Section B, Item 7).
(b). FIRM Zones V1 •V30, VE, and V (with SFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, i6 at an elevation of+_ i I I II feet NGVD (or other FIRM datum-ut Section B, item 7),
(c). FiRM Zone A (without 8FE), The floor used as the reference levet from the selected diagram is LJ -J.0 feet above 0 or
below [] (check one) the highest grade adjacent to the building.
(d). FIRM Zone AQ. The floor used as the reference level from the selected diagram is ;_L.iILJ feet above 0 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 aceordanee with the communtty'r floodplain management ordinance? 1) Yes ❑ No ❑ Unknown
3. i406 the elevation datum system used in determining the above reference level elevations: 29 NGVD '29 ❑ Other (detocrlbo
under Comments on Page 2). (NOTE: 9 the elevation datum used i1t measuring the 0104 ons is di1Ylrint Olin shot usod on
fro FIRM (sea SwNion 8, iter» 71, then Convert the elevations to the dotum systdm used on the FIRM end show #4 owmA Ion
Oquallon under Comments on Palo 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes 3 No (See Instructions on Page 4)
3, The reference level elevation Is based on: 59 actual construction L construction drawings
(NOTE, Use of cawtstnration drewings Is only v -0d if rhe building does not yet have the reference iow floor' in p1004, in wh ah
Cess tale X15020 wX only be valid for ow bullding during the course of oortstruction. A post-consWctbn ,E'tMOM Cavtllscets
tl X be iequlrad o ve consmAcean a complete.)
S. The elevation of the bwaat grade lmmediatoly adjacent to the building is: feet NGVD (or other FIRM dotum-see
Section B, iMr» 7).
SECTION D COMMUNITY INFORMA"11ON
1. N the community official rt3aponsibse for Verffying building elevations spoCfts that ft reference level Indicated in Section C, Ibm f
ie not ft "lowest %Oro 88 defined im the COMMUnity's ftoodplaln management ordinance, #W 4le4tion of tete building's'bust
OW as defhW by ft ordinance it: E i I I I I .LJ feeNGVD (or otfwr FIRM datum -see Section B. Ibm 7).
L Date of the stag oreonetruction or sub tantlai Improvemenx_.....` _
1lMA lone etas, Mar !0 Rt PLACES ALL PREVIOUS toltIONS tllE KVEI a etas FOR CONTWW*N
lar-'ta -%-95 TUE _ 1 3 0.4 DAV I S LAND SUR V CO I NC -P . 02 -
SECTION E CiEt PROATION
This MV11000A is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to Certify elevation
Information whotr the elevation information for Zones Al --MO. AE. AH, A (with SFE),V1»V30,VE, and V (with Bt=E) Is required,
Community officials who are authorlxed by lout taw or orciinanoe to provide floodoWn management information, may also sign the
oartii*rcatian. In the 083e of Zones AO And A (without a FEMA or c0mibun4 iuo#d BFE), a building official, a Wgxrty OWnAr', of an
owner's repreew►hWve may also sign the a►rtt6tWon.
Reference level dlagrams 6, 7 and 8 • Distinguishing F98turas—M the certifier Is unable to certify 10 breAkawaylnon-breakaway will,
er+Ciosure else, IoCetiOn of servici equipment, area use, wail openings. or unfinished pnla Feature(s), then list the Feature(s) riot
Included in the cvrtifrcatlon under Comments btelow. The diagram number, Section G, item 1, must WD] be entered.
I ovrtity that the Irtformagon In sections 8 and C on this oedricate tWesents my best efforts to lrrttrprot the dots available.
I understand that any 40!80 SteteMent may be punishable by line or lrnp4sonment under f0 U.S, Code, Sectfvrt 4004.
Robert L. W r i pt.N*t
CERTIFIERS NAME
Sr.y uEe.
Pres i de"+ N
2PLS
"0. 3q l7 (Texcas
LICENSE Ni1MBSA (or Aft Sao
dha ren w rVg j.%t Las k -e L, a rug rs .
rroe Sv(+e tCM 0
4-G-95.- (214)3.5-7-2.981
7AT,2iP
DA'ri PSE
CoAles should be made of this C r ificaite for: 1) community official, 2) insurance egenveompany, and 3) building owner.
OOMMENTS:
ON WMIALAI NAMMEW ON,hLts,
raartr oh aowMNs
R V A A d
zowae ZQKS ragas Miss zooms
ATIC
�L jl rN� Il• ��
PLOW j, ; `.w t, MRIIfNCR
M-211- � !1'$t
The diagrams above illustrate the points at which the elevations should be mea vmd in A Zones and V zones,
Elevattone for dt A Zvm should be measured at the top of the reference levet Noor.
Elevations for all V ZOnos should be measured At the bottom of the lowest horizontal structural member.
Pape 2
N$EDRAN WRIGHT LaSKEY ENGINEERS, INC.
10290 Y PMP. DRIVE, SUITE 305
D.Z.i18;, '1'EZ�18 75229
(214) 357-2981 SURVEY PLAT
TO ALL PARTIES INTERESTED IN PREKISBS SURVZYED:
This is to certify that the Survey hereon represents the results of
'an on -the -ground survey made under my direct supervision of
property located at No. , in the City of
Coppell , Texas, described as follows:
Lot No. 10-1 Block No. I , City Block No. , of
North Lake Woodlands
Addition, an addition to the City of
Coppell , Texas, according to the final plat recorded in
Volume 94_133 at page 509_7 of the Deed Records of
DoIlos County, Texas.
J3\
41
FORM SURVEY
14 to I
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14 2 13.IS ?B
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S F. 482.30
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15' S.S. ESMT.
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2 y�
0
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FLOODWAY ESMT— v�
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Phe plat hereon is a true, correct, and accurate
representation of the property as determined by
survey, the lines and dimensions of said property
being as indicated by the plat; the size,
Location, and type of buildings and improvements
ire as shown, set back from property lines the
3istances indicated, and there are no
ancroacimsents, conflicts, or protrusions, except
is shown hereon.
CO
N
M
Scale IN = 50, nO 9-;RQ�
REV. 10 -31- 94
Registered Professidhar Land Sur
NO. 3917
Mie 10-18-94