FEMA-EC020529T H E • C 1 T Y O F
COPPELL
BUILDING PERMIT APPLICATION "VI►n
I i7 /1 41 r7rl Print or Type in a Clear, Legible Manner
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Job Address: 1 1 , V ,I V
Date: /,-,[,0
Lot: Block: Subdivision:
A'Av 4:110 /+ Phase or Section Number:
Owner: Address:
/1 `s"01 % Phone A
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Contractor: Address:
s j �� Phone # 97Z, L L6 2 -172-
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Description of Work to be Done Class of Work: IV New
❑ Addition [A Alteration ❑ Repair ❑ Demolition
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Area of Building in Square Feet
First Floor .29?7 Garage �' 2-. Value of Work ��% d a v
to be Performed E�
Second Floor � Other ��
511 iv Sr- GRAY AREA FOR OFFICE USE ONLY
NOTICE
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This permit becomes null and void if work or construction authorized is not commenced
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within 180 days, or construction on work is suspended or abandoned for a period of 180
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days at any time after work is commenced.
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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
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presume to give authority to violate or cancel the provisions of any other federal, state
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or local la re ulatin construction or the erformance of construction.R
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Signature of actor or Authorized Agent Pri t Name
, 2A IR WER70"R {� &
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Electrical Contractor Plumbing Contractor Mechanical Contractor
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
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FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Read the instructions on pages 1- 7.
O.M.B. No. 3067-0077 -
Expires July 31, 2002
SECTION A- PROPERTY OWNER INFORMATION i For InsuranaeCcnvanyUse:
OWNER'S NAME
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.I Company NAIC Number I
717 WAVERLY LANE
CITY
STATE
ZIP CODE
COPPELL TX 75019
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 2 BLOCK D OF MAGNOLIA PARK ADDN.
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):
( #lir° - ## - ##.##R' or ###.) E NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ® Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
RAW W. STATE
B1. NFIP
480170NrfY NAME & COAnvAJNITY NUMBER DALLAB2. COS I TEXAS
64. MAP AND PANEL
135. SUFFIX
B7. FIRM PANEL
Datum Conversion/Comments
B9. BASE FLOOD ELEVATION(S)
NUMBER
B6. FIRM INDEX DATE
EFFECTIVEREMSED DATE
B8. FLOOD ZONE(S)
(Zone A0, use depth of WN)
0155
1
08-23-M
❑ b) Top of next higher floor
X
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B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entereo in bv.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other (Describe):
611. Indicate the elevation datum used for the BFE in B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date_
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings' E Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when constriction 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, ARIAH, AR/AO
Complete Items C3. -a4 below according to the bulling 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 E No
Lla) Top of bottom floor (including basemenor enclosure)
08t
467.. ft.(m)
5isTe'�p.
❑ b) Top of next higher floor
_ft.(m)
_
LJ c) Bottom of lowest horizontal structural member (V zones only)
_. _ft.(m)
00
HARRY ROWELL
❑ d) Attached garage (top of slab)
_ ft.(m)
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❑ e) Lowest elevation of machinery and/or equipment
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l 0 PPESSIG;01 4
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servicing the building (Describe in a Comments area)
_. _ft.(m)
E 6
❑ f) Lowest adjacent (finished) grade (LAG)
_. _ft.(m)
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SLTR
❑ g) Highest adjacent (finished) grade (HAG)
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❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
❑ i) Told area of all permanent openings (fkxxl 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.
I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Section 1001.
CERTIFIERS NAME HARRY ROWELL LICENSE NUMBER 4597
TITLESURVEYOR COMPANY NAME HARRY ROWELL COMPANY
ADDRESS CITY STATE ZIP CODE
1301 ELM STREET STE. 201 CARROLLTON TX 75006
SIGNATURE DATE TELEPHONE
05-29-02 (972) 242-0679
FEMA Form 81-31, JUL 00 V SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
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I V LAlpk Lj 110, �. FORM BOARD
j U Z SURVEY REQUIRED
By DATE
Approval of the plans and specifications shall not be
construed to mean construction in direct con
with the City of Coppell Building Cada alnd
Ordinances. L 2 1 >L j&V- 't
A(� 1 OL4A FAP
GI�Yor G���LL
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HR SURVEY PLAT7 HR
LOT 2 BLOCK D OF MAGNOLIA PARK AN ADDITION TO THE CITY OF COPPELL, DALLAS COUNTY
TEXAS RECORDED IN VOL. 98145, PG. 506, OF THE PLAT RECORDS OF DALLAS COUNTY, TEXAS.
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COMMON AREA & DRAIN. ESMT.
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717 WAVERLY DRIVE
10 I hereby certify that on the 22NDday of MAY 2002 , this survey was made on the ground and this survey plat has been prepared as per the field
ol 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 Board of Professional Land Surveying. Unless otherwise noted, the
lo 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 shows visble easements, encroachments, conflicts, or
protrusions apparent on the ground.
OF
Date : MAY 23, 2002 ��`Q4 JOB # : 02-2154
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GF No. BARRY J. ROWELL
..................
19 4597 HARRY
LEGEND Scale: 1" = zo''�o�
1/2" Steel /Iron Rod Found a
Steel /Iron Rod Set wl Red Cap ROWE LL
Property Line By &Associates, INC.
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Wood Fence . — . — . — • — Surveying 8 Engineering
Chain Link / Wire Fence X—X—X—X—X
1301 Elm Street Ste. 201
Overhead Electric — E— E— E—Carrollton, Texas 75006 (972) 242-5679