FEMA-EC9907019W fX
The City With A Beautiful Future BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Job Address: + a I D I NNA43t_%— 0 UD
Date: ,— 4-9" 1
Lot: Block: Q Subdivision: W o o tet, wrN p S CrC0 PV eL L Phase or Section Number:
11 I' I
�O
Owner Lf-,KC' W3 6 ►� n�eS p l eq -c Address: `� c� c7 i -.A/1 , ��i i V t ��i Phone #: 4 d 3 3
Contractor: , Address: IL t Phone #: t `
Description of Work to be Done Class of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demolition
4W a47e
V J"V
Area of Building in SquaareFeet
First Floor � ` '� 4 T� Garage Soq- Value of Work
to be Performed
Second Floor �' ` (�""� Other
GRAY AREA FOR OFFICE USE ONLY
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
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction of the performance of construction.
Si to re of Contractor or Authorized Agent not Name
Z)A TLLW� NV(COL%
Electrical Contractor Plumbing Contractor Mechanical Contractor
LAW
BUILDING INSPECTION - WHITE, APPRAISAL - YELLOW, CUSTOMER - PINK
FPMC - 1 (4/94)
.z 51 5
ELEVATION CERTIFICATE OAIU NoJ(3l1) J
fxperrshlayJl, 199)
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 elevaticn information necessary to ensure compliance with applicable community floodplain management ordinances, to
':t?retire r�: proper irsurarce premium rate, and,'cr 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 I FOR INSURANCE COMPANY USE I
BUILDING VONER'S NAME POLICY NUMBER
/0l E RC E HOAl6 5_ INN— .
STREET ACCRESS (including Apt., Unit, Suite andlor Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
LOT i 6i or -K A THE IN0001-AM25 OF COPP61-4-
CITY STATE ZIP CODE
COPPE�� T6AA5
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 ZONE6.
BASE FLOOD ELEVATION
1
IREV4-l5-q4
(in AO Zones, use depth)
48070
00/0
E
AE
482.4
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): WNGVD'29 []Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a SFE for this building site, indicate
the community's BFE: I I I I I I.J 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 I .
2(a). FIR1N1 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 ' 14" L?J feet NGVD (or other FiRM datum—see Section B, Item 7).
(b). FIR%i 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 � i I I I ,LJ feet NGVD (or ether FIRM datum—see Section B, Item 7).
(c). FIRM Zcne A (without BFE). The floor used as the reference level from the selected diagram is 1.J feet above ❑ or
beicw ❑ (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 ❑ (check
ore) 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 El Unknown
rI`
3. Indicate the elevation datum system used in determining the above reference level elevations: t,o,l 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
tl'e FIRt.i (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion
equa';,cr, under Comments on Page 2.)
4. E:evaticn reference mark used appears on FIRM: �)4 Yes ❑ No (See Instructions on Page 4)
5. The reference level elevaticn is based on: X actual construction ❑ construction drawings
(%'OTE: Use of construction drawings is only varid if the building does not yet have the reference level floor in place, in which
c2sa G'us 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 eleva'icr, of the lowest grade immediately adjacent to the building is: i4'8 81.121 feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the ccmmurity 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 1 1 1 I,J feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement 5- ZD -99
FEMA Form 3I 31, MAY 90 REPLACES ALL PREVIOUS EDI'iOvi SEE REVERSE SIDE FOR CCNTINUA'ICN
SECTION E CERTIFICATION
T - is cer,iflcation is to be signed by a land surreyor, engineer, or architect who is authorized by state or local law to certify elevation
rf,rrrat.on when the elevation information for Zones Al—A30, AE, AH, A (with 8FE),V1—V30,VE, and V (with BFE) is required.
Ccrrrr,unity officials who are authorized by local law or ordinance to provide Ilcodplain management information, may also sign the
cert,f cation. In the case of Zones AO and A (without a FEMA or community issued 8FE), a building official, a property owner, or an
cw ,r ; representative may also sign the certification.
P.efer-:nce level diagrams 6, 7 and 8 - Distinguishing Features—If the cerlifier 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 ' re s) not
irc'uded in the certification under Comments below. The diagram numter, Section C, Item 1, must still iQF•
1%; T
"\S�c•F'�?
! certify that the information in Sections 8 and C on this certificate represents my best efforts to interpat��rla .
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Cod Sat3rtA•JOII't... '
NORMAN L .. NFAL
OR M L. /VEAL 436 ....
C_RTFiE.R'S NAME UCEENSE NUMBER (or Affix Seal) 94z�
E tlEL.O .�I /D ANG
T''== COMPANY NAME
.38!!1 CAVAL/ER GA9/_4N0 TExAs 750¢2
A✓CRE33 CITY STATE ZIP
i-/-49 (972- Z72 -Q35
DATE PHONE
-Copies'shouid be made oft ific a for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS: _
ON carni ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A v A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
`cVE�NCE BASE LEVEL REFERENCE
'( I FLCCC I. LEVEL
EL-VAT'CN
t E '
9A$. BASE
ACJACENT "E'`ENKE FLCCC
GRACE "' L EL ELEVATICN
_=ERENCE ACJACENT
cl°v El GRACE
I
ACJACENT.�.
GRACE
Tse biayra,ms above ilius;rate the points at which the elevations should be measured in A Zones and V Zones.
E:evatens fcr all A Zones should be measured at the top of the reference level floor.
E'evations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2
FORM
I , NO/�MANe AL
NO . -1431 --, DO HEREBY
VI IZII'ICATIONS WERE MADE
T11H PROPOSED RRSIDRNCH
I,OT I
CITY OF
COPPELL
C 1.:�a It'l ;�:1�' J. C 1 `1' f ON
REGISTERIiD PROFIsSSIONAL LAND SURVEY01z
ChRTIFY THAT ON 5-;�o-O9
ON THE IIORII,ONTII,AY—O—U—T OF THE' I'OII1dS FOR
AT `i'III STREET ADDI2I�SS :
/0 NiNo1NG #OCLON✓ (AAlE OF
UI' 1100 >LAAID5 QF COPPED
- %JRLLAS COUNTY, TIiXAS.
FIELD MEASUREMENTS ARE AS SHOWN JIBRBON, IB; 25'=011
12, -Il
L 25, PR NT Flu
ro
WALL { LAND,CAFE EsM'r(AR'A2
ri _
i� f -- __ ` I
CONCRETE WALK AND CURB -
AS RECUIRED BY CITY
WINDING HOLLOW
SCALE- i"=20
REGISTERED PROFESSIONAL LAND SURVEYOR
FIELD AID, INC.
3814 CAVALIER DRIVE
GARLAND, TEXAS 75042.
PHONE (972)272-9358 FAX (972)272-7315