FEMA-EC980120 (4)The City With A Beautiful Future BUILDINGi7PERMIT APPLICATION*O C T 161997
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Job Address: Date:
• Lot: Block: Subdivision: Phase or Section Number: C R"�' V e,
Owner - i �� .S Address:, j Phone #:
Contractor: �.� Address:p� x Phone #: f )7
Description of Work to be Done Class of Work: few ❑ Addition ❑ Alteration ❑ Repair 7 ❑ Demolition
Area of Building in Square Feet
First Floor 1930
�1 n
Second Floor
NOTICE
Garage 6( 7 7
Other L
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 constructio^ ^r rhe performance of construction.
Signature of Contractor or Authorize Agent Print Name
bit Eflc�
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
Value of Work vG
m
to be Perfored 1-72 D J� �-'
GRAY AREA FOR
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
R
O.M.B. NO. 3067-0077
ELEVATION CERTIFICATE Expires May 31, 1996
• FEDERAL EMERGENCY MANAGEMENT AGENCY
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
provide elevation information 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).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNER'S
FOR INSURANCE COMPANY USE
POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
I.
OTHER DESCRIPTION (Lot and Block Numbers, etc.
k-0 'r Z
CITY r—, -�— /l r-.OUATE ZIP CODE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions): J. -d'7 Co
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM I)D
f'
5. FIRM ZONE
6. BASE FLOOD ELEVATION
(in AO Zone), use depth)
60 / 70
oolo
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): NGVD '29 L1 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: [-]-.I I 1 1. LJ 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 --7— .
2(a). FIRM 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. 41�1. Ueet NGVD (or other FIRM datum–see Section B, Item 7).
(b). FIRM Zones V1 -V30, 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 11-Li_1.I_1 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 L11 . U 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 feet above ❑ or below Ll (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? [I Yes LJ No [1 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 F71:/Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation is based onctual construction Ll 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: L_I_ ��I! I .� 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: L_L_J I 1 111 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, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
A
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.
1 certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
NAME
TITLE ^ P
ADDJREEESSSS cl Y
Copies should be made of this Certificate for: 1) comma—My-efffcia
LICENSE NUMBER (or Affix Sea])
DATE
insurance agent/company, and 3) building owner.
ZIP
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A v A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL REFERENCE
REFERENCE BASE LEVEL
LEVEL FLOOD
ELEVATION
v{:;4�I:.Si:'_ ilk'.'•".r
BASE
BASE REFERENCE FLOOD
ADJACENT ELEVATION
FLOOD LEVEL
ELEVATION REFERENCE ADJACENT GRADE
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
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SUNRISE DRI1�E
Innovative New Ideas
PLOT PLAN
For Traditional Home Design
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LOT 2, BLOCK G
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�TEXAS
P1RST TEXAS HOMES
14AJEK (REV4/IbAM)
Residential Designers and Planners
BRI -44—A7242)
Arlington, Texas Metro 817-261-4121 FAX 817-274-4717
• Builder/Owner to verify and check all aspects of this site and plot plan prior to any construction
SURVEY PLAT OF
"10 ALL PARTIES INTERES'T'ED IN PREMISES SURVEYED:
vnd there are
encroachments upm the adjoining property or the adjoining imprmements vpm the 0ocrihed property known as --- _—
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113 S WAW-1SE. DP-IVE
STA'rE OF TEXAS
COUNTY OF TARRANT
" In the Lienholders and/or the Owners of the Premises surveyed and to
The undersigned does hereby certify that this survey was this day made
on the ground of the property legally described hereon and is correct. and that
there are no discrepancies, conflicts, shortages in area, boundary line conflicts,
encroachrnems. overlapping of improvements, visible lines or roads in place,
excrpt m shnwn herron, and that said property has access to and from a
drelicated roadway except as shown hereon."
Dated:
[IASIS FOR IIFARING:
Order No. -- -_.- NOT FOR CONSTRt1CTION
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FLOOD NOTE: I hereby certify th, d1�es ixsI!1aA9t
;�Gr=e,i�no:
theprnpertywithin a special flood hazard area as identified by the
Federal insurance Administration. Department of Housing and Urban
Development, the flood hazard arca being identified as
of the Federal Insurance Administration Flood Hazard
Boundary Map effective on
for the
fly: - --- — -- --- ---- -
AP SURVEYING CO.
David Pollard RPS #1518
1903 Central Drive, Suite 309
Redford, TX 76021 Metro (8 17) 267-1249