FEMA-EC931215Th0CHWYWdAagWdINUM lua BUILDING PERMIT APPLICATION 93
is,�ra,,W t.,spe�,u MAW= Print or Type in a Clear, Legible Manner ►; ; ;
Job Address: 2Date:
Lot: 2 Block: Subdivision:L phase or Section Number:
Owner: Address: SD !D LI3:!r 50 k 719 141MPhone #: ?�
Contractor: i Address: Phone #:
Description of Work to be Done Class of Work: OKew []Addition ❑ Alteration ❑ Repair ❑Demolition
r
l
Area of Building in Square Feet
First Floor Garage Value of Work
to be Performed
Second Floor Other
GRAY AREA FOR OFFICE USE
NOTICE
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
Oys-m4prity to violate or cancel the pro3We®.Qf any other federal, state or local law
or
Name
Electrical Z`t111Gactor Plumbing Contractor Mechanical Contractor
SIR . 1 12192)
M
ELEVATION CERTIFICATE gZ';,M ��;'°05
FEDERAL EMERGENCY MANAGEMONT AGIkNCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of fids cwtifldite doer not provide a waiver of the flood insurance purchase rrMulrem.m, This form Is used only to
Provide elevation Informabn necessary to ensure COmpflenct with applicable conntnunity floodplain manegernent orawwwor. to
determine Ile Proper inewaries prenslurrt rete. andror to twpport as request fere Loner of Map Amendment at Revision (LOMA or LOUR).
Instruedo w for eorntSwung Ihle (orifi can IM found do the ldlkv* Mg Pager.
SECTION A PROPERTY INFORMATION ooh INSURANCE COLW%W use
BUILDING OwHER's NAME FDLiCIt rttrAtelR
STREET ADDRESS 11n dw" Apt., tAIK, Sera &Mbar dude Hum" OR P.O, AOUTV ANO 407( mAMER Cour my NMC W.""
201 WkLSk4k&2 DtLtVE
omen 0W.Airm" (L'" W" Mom M,Iesaa. MILI -
Lot 29, Block Q , EAGLE POINT VILLAGE AT RIVERCHASE
CITY
C O p p e l l STATE TX zip CODE
SECTION 9 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Insouctlonsl.
I. cOwuuNlrY Nuuean
L FAME6 NIM &M
SUFFIX
4.OAr1t OF FUW WQQX
L FIRM ZON9
a. awSE FL000 ELEVATION
450170
0010
D
Oct. 16, '1991
X (Shaded)
In AO 2a.e., %." 0804101
' . '^. "Isveaorr varum system used On the FIRM for Base Flood Elevations (BFE): L1U NGVO '29 U Other (describe on back)
9. For Zones A or V. where rte WE It provided on the, FIAM* and lite community has established a BFE for this building site. Indicate
the community's BFE:I,(.,,) rest NGVO (or other FIRM dattsn"oo Section 13, Item 71,
SECTION C BUILDIN,; ELEVATION INFORMATION
1. Using the Etavation Certificate Insttrucnorts, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the Subiect building's reference level _I .
2(a). FIRM Zones At -A30. AE. AN. and A (wish WE). The top of the reference level floor from the selected diagram is at an elevation
Of I 448 2 — -'a" NGVO (or other FIRM datum -ser Section S. Item 71.
(b). FIRM Zones V 1430. VE. and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected dlv4mm, is at an elevation of 1 1 I I 1 t U 100 NGVO (or other FIRM datum -see Section B. Item 71.
(c). FIRM Zone A (without BFE). The Now used as the refererlee level from the selected diagram is W .0 loot above ❑ or
below ❑ (check one) the highest grade ad(acent to the building.
(d). FIRM 7.one AO. The now used as the reference level from the selected diagram is I .0 feet above ❑ or below ❑ (check
one) the highest grade ad(acent to the building. If no NOW depot number is available. is the building*$ lowest Iloor (reference
level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
9. Indicate the elevation datum System used in determining the above reference level elevations: ❑ NGVO '29 0 Other (describe
I.Inder Comments on Page 2). (NOTE. N Nle slevmiort donari used in nreisix" /hr srevanons is dillerenr Inan that used on
rhe FIRM [300 Scothern A, Nem 71 fherl commeq rhe slevatIOM to Ned datum system used on the F1nM and show the conversion
aquanort writer Comments an Page 2.)
4. Elevation referom:e mark used appears on FIRM: ❑ Yes ❑ No (Ser Instnicdons on Page 4)
5. The refersnce level elevation is based on: 0 actual construction ❑ Construction drawings
(NOTE. Use or consrrucrron drawings is only valid it thi b&WAO q does nW yet have fhe relNertee level Trow in place. in whfeh
cess "s cerrlMcars w`# only be veld for the budd V during tlne COWS& W eonsrrucbort. A post-carsinxIlOn Elevanon Carnricare
we# be required once construction is cornplere.)
S. Tits elevation of the lowest grade immediately adjacsnt to the building is: LU I I I,(,,,,J feet NGVO (or other FIRM datum -see
Section B, Item 7).
SECTION O COMMUNITY INFORMATION
1. II the community onlciai.resPonsible for verifying building elevationtt 1pecltiee that the reference level indicated in Section C. Item 1
11 not the lowest door' as donned in the commtOWS noodplaln managerna I ordinance. the elevation of the building's 'lowest
floor as defined by the ordinance Ill: LJ- I I 1 I,U IeN NGVO (or other FIRM dalurn-!ee Section 9, Item 7).
2. Date of the start of construction a substantial- irnproveffloM
rtrwA ra.w at-]tr MA• •o REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIOE FOR CONTINUATION
SECTION E CERTIFICATION
I Iris rertilicstino 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 lot Zones At -A30, AE, AH, A (with 8FE),V1-V30,VE, and V (with BFE) is required.
('rnTrrnunity officials v/ho are authorized by local law or ordinance to provide floodplain management information, may also sign the
rerlificalion. In the case of Zones AO arid A (without a FEMA or community issued BFE), a building official, a property owner, or an
nwner's representative may also sign the certification.
nrompnce level dingrnms 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall,
enCIOSLrre Size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
inrlurfed in the certification under Comments below. The diagram number, Section C. Item 1, must still be entered.
I rrrlNv that flip information in Sprfions B and C on this certificate represents my best efforts to interpret the data
I Understand thni Int• fF lrt, 1101011lent MAY be Pfnrishistile by tiny er Irnpf7Anmmanr under 10 U.B. Cede, aeCNo ji
(1111It 11:11S NAMF LICENSE NUMBER lot A81■ Seel)
Glenn W. Miller Geodata Surveying, Inc .
Mn
- -- -- --- - - .....---------- -- _ GLENN W. MIDI -
r IT LF COMPANY NAME
Surveyor
_
ADDFIFSS clivi ---------------------- � � ------
,.. �•� ZIP
P.O. Box 13556 Arlington____
Irt1nt11r1F DATE 8E261-2878
�12- is -°J 3
Copies should be made of this Certificate for: t) community official, 2) Insurance agent/company, and 3) building owner.
COMMENTS: Benchmarks used to determine this elevation are taken from engineerin
plans used in the construction of the subdivision (Nathan D. Maier Cons.
Eng.neers) and have not been verified with the FEMA reference mark
elevations.
r11�-T WI11, ON PILES,
SLAB BASEMENT PIERS. OR COLUMNS
A V A A v
7()NES 70NES IONES 70NE-S 20NES
= nEFENENCE
1Fo 1E1IR �,':f BASE LEVEL
REFENENCE
IEVE� FLOOD
L1
ELE vAII1lON
tr
L'&SE I.... ADJACENT •h'. nEFERENCE
Itoo0 nNADE Ir: IEVEt
ElEVA1 VrN 1IFFB1ENCE ADJACENT
NASE
F1000
ELEVAVIM
LEvIt GRAM.
wQJACtNt
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.
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1'UT SH WING
lie i n�, I,ot 20 in It I rick .A nf FACI,E POINT V L1,I:At;I' ;%T RIVE.PCHASE,
on Addition to thr City of livini;, T'ex.:�_;, �1((ordiil" to the
Map r e( of ied if' VO t Ume 9V 55 , Pnge 004'1 of t ho 'lap Pe I d
of 1)a1 las Co11nt v. Tex,is.
CO[T)F1()nly known a� 201 Wi ir;hire 1),ivc,.
Tr��; k PE N' S '_' �' '- IN :' NE � ;) X(-.tt M �,S [ Et INEaTED ON �_OOD 'NSURarJCE RATE MAP
r -'ANE!
No 48°110 0010 D Fc ✓E Dt'krF OUT 16�-t_.—_. L�)CAL,LED F:.t�ODING
P O. Box 13556 • Land Surveying
Arlington. Texas Ldnd Planning
GECIDATA SURVEYING, INC. 76094-0556 • Tpagraphic
Metro 261-2878 Mapping
o
LEGEND
� irur ; CC1
x x _ 'P,nce ne
- T— - E- IWe
I hereby certify this to be a true and correct representation of a
survey made on the ground under my supervision and there are
no visible encroa hments or protrusions except as shown.
GLENN W. MILLER R P L S STATE OF IEXAS NO 4223
DATE_��._-15