HomeMy WebLinkAboutlot50ElevationCertU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
OMB No. 1660-0008
Expiration Date: November 30, 2022
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.
FEMA Form 086-0-33 (12/19) Replaces all previous editions.Form Page 1 of 6
A1. Building Owner's Name
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
City State ZIP Code
Policy Number:
Company NAIC Number:
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.)
A5. Latitude/Longitude:Lat. Long. Horizontal Datum:NAD 1927 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
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s)
sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in
d) Engineered flood openings?Yes No
A9. For a building with an attached garage:
a) Square footage of attached garage sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade
c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings?Yes No
SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2. County Name B3. State
B4. Map/Panel
Number
B5. Suffix
B6. FIRM Index
Date
B7. FIRM Panel
Effective/
Revised Date
B8. Flood
Zone(s)
B9. Base Flood Elevation(s)
(Zone AO, use Base Flood Depth)
B10. 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:
NGVD 1929 NAVD 1988 Other/B11. Indicate elevation datum used for BFE in Item B9:Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?Yes No
Designation Date:CBRS OPA
FOR INSURANCE COMPANY USESECTION A – PROPERTY INFORMATION
D.R. Horton, Inc. (15-141.004.050)
3238 Trinity Circle
Fort Pierce Florida 34945
Creekside Plat No. 4, Lot 50; Parcel ID: 2327-502-0058-000-2
Residential
27.404861 N 80.419894 W
1B
0.00
0
0.00
450.00
0
0.00
St. Lucie County, 120285 St. Lucie Florida
12111C0170 K 02-19-2020 02-19-2020 AE 16.9'
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
FEMA Form 086-0-33 (12/19) Replaces all previous editions.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
City State ZIP Code
Policy Number:
Company NAIC Number
SECTION C – BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on:
*A new Elevation Certificate will be required when construction of the building is complete.
Construction Drawings* Building Under Construction*Finished Construction
C2. Elevations – Zones A1–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:Vertical Datum:
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)feet meters
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
feet meters
feet meters
feet meters
feet meters
feet meters
feet meters
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. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Check here if attachments.Yes NoWere latitude and longitude in Section A provided by a licensed land surveyor?
Certifier's Name License Number
Title
Company Name
Address
City State ZIP Code
Signature Date Telephone
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
Form Page 2 of 6
Ext.
3238 Trinity Circle
Fort Pierce Florida 34945
AF6653 NAVD 1988
19.1
N/A
18.3
18.9
18.2
18.7
N/A
N/A
Thomas P. Kiernan 6199
Professional Surveyor
Culpepper & Terpening, Inc.
2980 South 25th Street
Fort Pierce Florida 34981
(772) 464-3537
The elevation referenced in Section C2, item e) is: A/C pad at rear of building.
206
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
FEMA Form 086-0-33 (12/19) Replaces all previous editions.
State ZIP CodeCity
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Company NAIC Number
Policy Number:
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 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).
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is
a) Top of bottom floor (including basement,
crawlspace, or enclosure) is feet meters above or below the HAG.
metersfeet below the LAG.above or
SECTION F – PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
E2. For Building 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.
feet meters above or below the HAG.E3. Attached garage (top of slab) is
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 Unknown.No The local official must certify this information in Section G.
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
Telephone
Comments
DateSignature
Check here if attachments.
Form Page 3 of 6
Florida 34945Fort Pierce
3238 Trinity Circle
Thomas P. Kiernan
2980 South 25th Street Fort Pierce Florida 34981
(772) 464-3537
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
FEMA Form 086-0-33 (12/19) Replaces all previous editions.
ZIP CodeStateCity Company NAIC Number
Policy Number:Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
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.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. Community's design flood elevation:feet meters Datum
Comments (including type of equipment and location, per C2(e), if applicable)
Local Official's Name Title
TelephoneCommunity Name
Date
Check here if attachments.
Signature
Form Page 4 of 6
34945FloridaFort Pierce
3238 Trinity Circle
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
FEMA Form 086-0-33 (12/19) Replaces all previous editions.
BUILDING PHOTOGRAPHS
See Instructions for Item A6.
Policy Number:
Company NAIC NumberZIP CodeStateCity
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
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.
Form Page 5 of 6
Photo One
Photo One Caption
Photo Two
Photo Two Caption
34945FloridaFort Pierce
3238 Trinity Circle
Front/Right 1/4 angle 10/14/2020
Rear/Left 1/4 angle 10/14/2020
Clear Photo One
Clear Photo Two
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
FEMA Form 086-0-33 (12/19) Replaces all previous editions.
BUILDING PHOTOGRAPHS
Continuation Page
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.Policy Number:
Company NAIC NumberZIP CodeStateCity
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.
Form Page 6 of 6
Photo Three
Photo Three Caption
Photo Four
Photo Four Caption
3238 Trinity Circle
34945FloridaFort Pierce
Clear Photo Three
Clear Photo Four