HomeMy WebLinkAboutEvaluation Report (2) U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30,2022
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and(3)building owner.
SECTION A—PROPERTY INFORMATION FOR INSURANCE-COMPANY USE
Al. Building Owner's Name Policy Number:
GLEN &NANCY WIERSEMA
A2, Building Street-Address(including Apt., Unit, Suite, and/or.Bldg. No.)or P.O. Route and Box No. Company NAIL Number:
83 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH Florida 34957
A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
PARCEL 83,'NETTLES ISLAND INC,A CONDO SECTION II (#4502-501-0269-000-4)
A4: Building Use(e.g., Residential, Non-Residential,Addition;Accessory,etc.) RESIDENTIAL
A5:`.;Latitude/Longitude: Lat.27°17'12.6816"N Long.-AW.1327.9128"W Horizontal Datum: ❑ NAD 1927 .❑x NAD 1983
A6..Attach at least 2 photographs of the building if the Certificate is.being used to obtain flood insurance.
A7. Building Diagram Number 8
A8. Fora building with a crawlspace or enclosure(s):
a).Square footage of crawlspace or enclosure(s) 1030.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0.00 sq in
d) Engineered flood,openings? ❑Yes.. ❑x No
A9. For a building with an attached garage:
a) Square footage of attached garage 0.60 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of Rood openings in A9.b 0.00 sq in
,d) : nginee rkrlood-oeenings? ❑Yes ❑x No
= . .SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
B*..;NFIP Community-Name&Community Number B2. County Name B3. State
ST: b,' -.IE b0,UNINC,AREAS- 120285 ST. LUCIE Florida
B4. Ma01P jnel `B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Numbers = Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
12111 C0311 K 02-19-2020 02-19-2020 X N/A
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes x❑ No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 1 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022
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:
83 NETTLES BLVD,
City State ZIP Code Company NAIC Number
JENSEN BEACH Florida 34957
SECTION C—BUILDING ELEVATION INFORMATION'(SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑x 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,AR/AE,AR/A1—A30,AR/AH,AR/AO.
Complete Items C2.a-h:below according to the building diagram specified in Item A7.-In Puerto Rico only, enter meters.
Benchmark Utilized: 87Z2312 G TIDAL Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. --
❑ NGVD 1929 ❑x 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 bottorri'floor(including basement, crawls ace, or enclosure floor) 5.45 x feet 0 meters
b) Top of the next,higher floor 9.86 ❑x feet ❑ meters
c) Bottom of the lowesthorizontal structural member(V Zones only) N/A ❑ feet ❑meters
d) Attached garage(top of slab) N/A ❑ feet ❑ meters
e) Lowest elevation.of machinery or equipment servicing the building feet 47
(Describe type of equipment and location in Comments) 9. ❑ ❑ meters
f) Lowest adjacent(finished)grade next to building(LAG) 4.78 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 5.04 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support 5.43 ❑x 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.
1 certify that the information 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.
Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
STEPHEN J. BROWN, PSM L.S.4049
Title .
PROFESSIONAL SURVEYOR AND MAPPER
r.
Company Name
STEPHEN J. BROWN, INC. Ise, >r E a _
Address _
619 / T 5TH ST ET
C' 1 State ZIP Code
TUART Florida 34994
1
Signature Date Telephone E
09-18-2020 (772)288-7176
Copy all pages levation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner.
Comme (i ding type of equipment and location, per C2(e), if applicable)
C2 OTTOM OF THE A/C UNIT
ROP RTY LIES IN THE'X'ZONE AND THE NEAREST FLOOD ZONE TO OUR PROPERTY IS "AE"WITH A BASE FLOOD
ELEV. OF 4.01
.
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 2 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30 2022
P ,
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:
83 NETTLES BLVD.
City State ZIP Code Company NAIC Number
JENSEN BEACH Florida 34957
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 E1—E5. If the'Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter meters.
E1. ,Rrovide elevation information for the following and check-the apprdpriate boxes to show whether the elevation is above or below
..the�high'est adjacent grade(HAG)and the lowest adjacent grade(LAG).
a) Top of bottom floor(including basement,
crawlspace, or enclosure)is ❑feet ❑meters ❑above or ❑below the.HAG.
b) Top of bottom floor(including basement,
crawlspace, or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG.
E2.`.For.Buildirig Diagrams 6-9 with permanent flood openings provided!in Section A Items 8 and/or 9(see pages 1-2 of Instructions),
the next higher floor(elevation C2.b in
'the diagrams)of the building is ❑feet ❑meters ❑above or ❑:below the HAG.
E3..Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top-of-platform of machinery and/or equipment ---
servicing the building is ❑feet ❑meters ❑above or .❑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? ❑ Yes ❑ No ❑: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 or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments.
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 3 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022
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:
83 NETTLES BLVD.
City State ZIP Code Company NAIC Number
JENSEN BEACH Florida 34957
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 architectwho is-authorized by law to certify elevation information..(Indicate the source and date of the elevation
data in the Comments area below.) -
G2 ❑ 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. ❑ 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: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)
of the building: ❑ feet ❑ meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. 9
Community's design flood elevation: E] feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments(including type of equipment and location, per C2(e), if applicable)
❑ Check here if attachments.
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30,2022
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:
83 NETTLES BLVD.
City State ZIP Code Company NAIC Number
JENSEN BEACH Florida 34957
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.
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Photo One Caption FRONT VIEW 09/15/2020 I Clear Photo One
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Photo Two Caption REAR VIEW 09/15/2020 Clear Photo Two
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30,2022
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:
83 NETTLES BLVD.
City State ZIP Code Company NAIC Number
JENSEN BEACH Florida 34957
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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.
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Photo Three —
Photo Three Caption SIDE/REAR VIEW 09/15/2020 !Clear Photo Three
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Photo Four Caption REAR/SIDE VIEW 09/15/2020 Clear Photo Four
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 6 of 6