FEMA-EC010320W1, 'goa(6'3
BUILDING PERMIT APPLICATION
171/.57 / Print or Tvne in a Clear. Leoible Manner
Job Address: '� 13 w*v a ` L Ne
Date: 2 � a
Lot: 3 Block: Subdivision:
Phase or Section Number:
Owner Address:
C DA.!a.'
9 Phone #:
- %�-4-1G2- 2?
Contractor: Address:
�a�r° Phone #:
Description of Work to be Done Class of Work: New ❑ Addition
❑ Alteration ❑ Repair ❑ Demolition
�j IZ /- 2
>♦' L M 'Co
t Q IV
eJX
Area of Building in Square Feet
First Floor 2G 1?7 Garage O ��
Value of Work 44 ��
d
Second Floor � �"� � Other .27
to be Performed
GRAY AREA FOR OFFICE USE ONLY
NOTICE
Permit Fee:
, Receipt Number:
Zoning District:
Occupancy Classification:
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.
Approved By:
bete:.....
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
Comments:
C- f
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.
b
Signaturvief Contr ctor or Authorized Agent I Print Name
1L ri aMe L'c� if/ 'r'o
Electrical Contractor Plumbing Contractor Mechanical Contractor
FPMC - 1 (4/94)
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.I Company NAIC Number I
17/. ? U/',4 V,��L 61 .Ls�N,�
CITY STATE ZIP CODE
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
J o T
BUILDING USE (ea, Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: �_� GPS (Type):
( ##° ##' - ##.##" or ##.#####) 1_1 NAD 1927 111 NAD 1983 �_� USGS Quad Map 1_1 Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAMEB3. STATE
e RP CL 8o/ ?'d 1;V- i-'
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
I
DATE
EFFECTIVE/REVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
FIS Profile �� FIRM ✓Community Determined �_1 Other (Describe):
B11. Indicate the elevation datum used for the BFE in 139: 1__1 NGVD 1929 1__1 NAVD 1988 1_1 Other (Describe): -------- ___
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? I_1 Yes 1__I No
Designation
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 1_1 Construction Drawings* 1_�JBuilding Under Construction* 1__IFinished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number _l_ (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 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3.a-i 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 Conversion/Comments
Elevation reference mark used-- --- Does the elevation reference mark used appear on the FIRM?. .— Yes -No
❑ a) Top of bottom floor (including basement or enclosure) ------ %rL__ . _ern) co OF 7
❑ b) Top of next higher floor_______ ___ ft.(m)
❑ c) Bottom of lowest horizontal structural member (V zones only) ___---------- ft.(m) o oT�
❑ d) Attached garage (top of slab)___________ . ___ ft.(m) E
❑ e) Lowest elevation of machinery and/or equipment w 9
HARRY J. ROWED.
servicing the building (Describe in a Comments area.)____________ ___ ft.(m) E i •••••»4
❑ f) Lowest adjacent (finished) grade (LAG)_____________ ___ ft.(m) z U)
❑ g) Highest adjacent (finished) grade (HAG)____________ . ___ ft.(m)
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
❑ i) Total area of all permanent openings (flood vents) in C3.h 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.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME , J�A4nV 00e0kJ.FZ'L �s-q LICENSE NUMBER
ADDRESS /ZQ/ ZG� `7l �� /�cd DtPeV� r%dX1 %,(Y. , %�DOSTATE 2DE
PPNAA Pnrm 81_11 .II II nn CPP: PP\/PPCF CIIIP POP r.(INTINI IATIr1N PPPI Ar.PC Al I PRF\/Ir)i IC r=nlTlr1NC
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ORM BOARD
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CITY OF COPPEU
WA, Mq-L� REVIEWED
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�PRrtivai of the ns and CspecMcations 9W net
ooh«! to mom construction in dirt oeiAN�,
uMlur *0 City of Coppsii ftNing sodas ad Zed
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SUPVEY PLAT HR
SOT 3 BLOCK D OF MAGNOLIA PARK AN ADDITION TO THE CITY OF COPPELL, DALLAS COUNTY
TEXAS REC. IN VOL. 98145, PG. 506, P.R.D.C.T.
COMMON AREA & DRAIN. ESMT.
R = 945'
90.73
o LOT 3
BLK. D
8.0
9.3 �
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0
FORMBOARDS o
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LOT 4 LOT 2
25' B.L.
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cn
93'04'40" J
77.35
R=720'
713 NAVE RLY LANE
I hereby certify that on the -_;=0TH day r.f _ MAR. , 20 01 this survev was made on the grnund and this survey plat has been prepared as per the field
notes thereby produced, and it properly represents the facts as found on the ground. This survey plat has been prepared In accordance with, and in
substantial compliance with , all rules and regulations promulgated by the Texas Hoard of professional Land Surveying. Unless otherwise noted, the
surveyor has relied solely on the record data provided in the title commitment for the determination of the boundaries of the land parcel surveyed and for
any easements of record which may be shown or addressed on the survey. The survey sho.Ts viable easements, encroachments, conflicts, or
protrusions apparent on the ground.
Date : MARCH 21, 2001 JOB# : 01 —
X
HARRY J. ROWELL�
_ GF Na.
— 4597 /
(D LEGEND (D Scale: 1" = 20'�°.,?�% HARRY
1/2" Steel Iron Rod Found O SUR�j
/
1/2" Steel / Iron Rod Set 0 ROWEL L
Property Line By : �& Associates, INC.
W,
Wood Fence -- —` Surveying & Engineering
Chain Link/ Wire Fence X—X— X—X—X 1301 Elm Street Ste. 201
Overhead Electric — E-- E— E—arrollton, Texas 75006 (972) 242-5679
77-�77 T7777"77TT/