FEMA-EC160123U,S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insiamrce Proparn
A1. Building Owner s Name Standard Pacific
Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
A2. Building Street Address (including Apt., Unif, Suite, and/or Bidg. No.) or P.O. Route and Box No.
622 Westhaven Road
City Coppell
State Tx ZIP Code 75019
OMB No. 1660-0008
Expiration Date: July 31, 2015
A3.
Property
Description (Lot and Block
Numbers, Tax Parcel Number,
Legal Description, etc.)
Lot 16,
Block
N, Westhaven, Phase 1, an addition to the City of Coppell,
Dallas and Denton Counties.
A4.
Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.)
Residential
A5.
Latitude/Longitude: Lat. 32059'14"N
Long, 97°00'35"W Horizontal Datum:
❑ NAD 1927
® NAD 1983
B5. Suffix
A6.
Attach at least 2 photographs of the building if the Certificate is being used
to obtain flood
insurance.
AT
Building Diagram Number 1 B
K
A8.
For a building with a crawlspace or enclosure(s):
A9. For a building with an attached garage:
AO, use base flood depth)
a) Square footage of crawlspace or enclosure(s) sq ft
a)
Square footage of attached garage sq ft
b) Number of permanent flood openings in the crawlspace
b)
Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade
within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in
c)
Total net area of flood openings in A9.b sq in
d) Engineered flood openings? ❑ Yes ❑ No
d)
Engineered flood openings? ❑ Yes ❑ No
c) Bottom of the lowest horizontal structural member (V Zones only)
❑ feet
❑ meters
SECTION B - FLOOD INSURANCE
RATE MAP (FIRM) INFORMATION
61. NFIP Community Name &Community
City of Coppell 480170
Number
B2. County Name
Dallas
B3. State
Texas
REQUIRED)
C1.
Building elevations are based on: ❑ Construction Drawings* ® Building Under Construction* ❑ Finished Construction
B4. Map/Panel Number
B5. Suffix
66. FIRM Index Dato
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
48113CO135
K
07/07/2014
Effective/Revised Date
Zone(s)
AO, use base flood depth)
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑ NAVD 1988
❑ Other/Source:
07/07/2014
AE
466
B10.
B11.
B12.
Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date: ❑ CBRS ❑ OPA
❑ Yes ® No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY
REQUIRED)
C1.
Building elevations are based on: ❑ Construction Drawings* ® Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2.
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 C2.a-h
below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Benchmark Utilized: See Comments Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑ NAVD 1988
❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 471.34
® feet
❑ meters
b) Top of the next higher floor
❑ feet
❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only)
❑ feet
❑ meters
d) Attached garage (top of slab)
❑ feet
❑ meters
e) Lowest elevation of machinery or equipment servicing the building
❑ feet
❑ meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent (finished) grade next to building (LAG)
❑ feet
❑ meters
g) Highest adjacent (finished) grade next to building (HAG)
❑ feet
❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
❑ feet
❑ meters
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 on this Certificate represents my best efforts to
interpret the data available.
l understand That any false statement may bo punishable by fine or imprisonment under 18 U.S. Code, Section 1001. .� Q� ®G' ',
000
Check .
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here if attachments, licensed land surveyor? ❑ Yes ® No o
Certifier's Name Allen L. Brewster 0 000 00(
Title R.P.L.S.
Address 6850 Manhattan Blvd.#310
Signature
FEMA Form 086-0-33 (7/12)
License Number 4054
Company Name Dowdy Land Syrveyors
City Fort Worth
Date
State Tx ZIP Code 76120
Telephone 817-429-9898
See reverse side for continuation.
'' LIa�NaP�� REWSiEI�
n00 xo 0oo00onaaao av°oo
0
a 4054 �XLW G
Replaces all previous editions.
ELEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces, copv the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
622 Westhaven Road
SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
CtElti
ommens eva ons are based on benchmarks provided by Kimley-Horn & Associates, the engineer and surveyor of record for Westhaven Phase 1.
Signature �— Date
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items El -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is El feet El meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is El feet El meters El above or E] below the LAG.
E2, For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is El feet El meters ❑ above or El below the HAG.
E3. Attached garage (top of slab) is El feet El meters El above or E] below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is El feet El meters [I above or E] below the HAG.
E5, Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? E] Yes E] No E] Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
[71 Check here if attachments.
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G
of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 -G10, In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. E]A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO,
G3. E] The following information (Items G4 -G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: El New Construction El Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: El feet
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
❑meters Datum
G9.
BFE or (in Zone AO) depth of flooding at the building site:
El feet
El meters Datum
G10.
Community's design flood elevation:
❑ feet
El meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3
Building Photographs
See Instructions for Item A6.
IMPORTANT: in these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, Policy Number:
622 Westhaven Road
City Coppell State Tx ZIP Code 75019 Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View"; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
t�• O