FEMA-EC000214The cRyWith ABeautHalFuture BUILDING PERMIT APPLICATION
Print or 1 ype In a Clear, Legible Manner
Job Address: /lew Date: .2 ig ^ oO
Lot: Block: Subdivision: Phase or Section Number: /
Owner / / Address: �S � J � Phone #:
Contractor: / Address:Phone #:
Description of Work to be Done Class of Work: New Addition ❑ Alteration ❑ Repair ❑ Demolition
/,r -C
Area of Building in Square Feet
First Floor. .3 Garage
Second Floor /3 / 6 Other
Valuof e
to be Performe orme Belo
NOTICE
rvt�nn sia..
This permit becomes null and void if work or construction authorized is not commenced
Zf ning strict:
within 180 days, or construction on work is suspended or abandoned for a period of 180 days
at any time after work is commenced.
Approvsd By:
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
Cornt11e11.
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.
✓/ /cce
gnature of C ctor or Authorized A nt tint Name
Electrical Contractor Plumbing Co tractor echanical Contractor
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
ELEVATION CERTIFICATE O.M.B. Nq. 3067- 0"F
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999
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 prc.-
vide elevation irrformation 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 Letter of Map Amendment or Revision (LOMA or LOMR). You are not
required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form.
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
POLICY NUMBER
BUIL ING WNER'S NAME
ST EET'Abl) S$ (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
OTHER DESCRIPTION Lot and6lock Numbers, etc.)
;.. '13 JY A
STATE ZIP CODE
CITY
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
2, PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. (In AO ASE LOne D ELEVATuse ION
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): LJ NGVD '29 LJ Other (describe on bacK)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: . U 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 diagrams found on Pages 5 and 6 that best
describes the subject building's reference level
2(a). FIRMS Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of L 1 11+5111. ft feet NGVD (or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1 430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of I I I I I ❑ 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 W . ❑ feet above ❑ or
below ❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W .❑ 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 ❑ No ❑ Unknown
3. Indicate the elevation 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 B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based on: ❑ actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.)
6. The elevation of the lowest grade immediately adjacent to the building is: feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level Indicated in Section C, Item 1
is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: I I I I I I .❑ feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CCNYTINUATICIN
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al -A30, AE, AH, A (with BFE),V1-V30,VE, and V (with BFE) is required.
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 issued BFE), a building official, a property owner, 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-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
! certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the a•Qvie
/ understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sel•
y'Q �STr�q�O•
t_ W)TIC...�................
CERT IER'S NAME �`� LICENS UMBER (or Affix Seal) •�•. .•_.��_• ��•�����•i•..
i•�"* 5190 P:�•
TITLEE� COMPANY NAME �•.•ESS�..•• O
U�oc� A1/4?.A1/4?.— SiTI�Ll U / ^�– S•• 3
ADDRESS CITYST zip
., I� Zoyv 2_q 23- 3 Z
RIC;NATI F i D - DATE PHONE
Copies shbuld be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: l
top v,L �Dli.y ll`f r, �Iv�+l �-t A>v D ) s a i !vim ►1� 1
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ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL
REFERENCE BASE
LEVEL FLOOD
RE FERENCE
LEVEL
ELEVATION
:f 4'::��::.:'n'.1:.
-
BASE
BASE ADJACENT:. ''' REFERENCE
FLOOD GRADE LEVEL
FLOOD
ELEVATION
ELEVATION REFERENCE ADJACENT
LEVEL GRADE
ADJACENT.`.
GRADE
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2
PROPERTY DESCRIPTION -
Address:-623 Stratford Lane Lot 6 Block A of Stratford Manor, an addition to the City of Coppell, Dallas County, Texas, according to the plat
thereof recorded in Volume 99167, Page 28 of the Map Records of Dallas County, Texas.
0
(CM) I LOT 7 s
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LOT 5
NOTES: (1) Source bearing is based on recorded plat unless otherwise noted. (2) Drainage arrows, if shown, were determined by elevations shown
hereon. (3) (CM) = Controlling monument. (4) Surveyor's seal will appear with red ink on certified copies.
CERTIFICATION
On the basis of my knowledge, information and belief, I certify to Wyndsor Homes that as a result of a survey made on the ground to the normal
standard of care of Registered Professional Land Surveyors practicing in the State of Texas, I find the plat hereon is true, correct, and accurate as to
the boundaries of the subject property, and if shown, location and type of buildings and visible improvements hereon, if any, and correctly shows the
location of visible easements and rights-of-way and other matters of record which are shown on the recorded plat or are a part of a title
commitment/survey request. Exce t as shown on the survey there are no encroachments or protrusions of visible improvements.
Scale: 1"=30 Date: 2/14/2000 Revised: Job No. 000269
Title commitment/Survey Request File No. dated
ISO T
ROOMS SURVEYING, INC.
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SUITE 804
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Phone Number (972) 423-4372 Fax Number: (972) 423-7523
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