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Home My WebLink AboutElevation Certificate'U.S. DEPARTMENT OF HOMELAND SECURIT` Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICAT Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 0,i^ -Aa SECTION A - PROPERTY INFORMATION 1 WIrfWWWfe"Mah°igl�s&21�°40_',191 A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 0' Pa 5606 Birch Drive � �, � ��.��1071 City Fort Pierce State FL ZIP Code 34982 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOt 19, Block 57, Indian River Estates Unit Eight A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential/Addition A5. Latitude/Longitude: Lat. 27.3626°N Long. 80.3059°W Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 6 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 187.2 sq ft a) Square footage of attached garage 0 sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings?' ❑ Yes ® No 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 Unincorporated St Lucie County'. 120285 St Lucie Florida B4. Map/Panel Number - B5.. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111C G Date ' Effective/Revised Date I Zone(s) AO, use base flood depth) 06/30/1999 11 /04/1992 AH 17 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in Item 69: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATIONINFORMATION (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, AR/AE, AR/A1-A30, AR/AH, AR/AO. Com below according to the building diagram specified in Item AT Use the same datum as the BFE. Benchmark Utilized NOS CAF 7512 Vertical Datum NGVD 1929 Conversion/Comments BM Elevation: 14.21 Check the measurement used. N N a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 17.75 ®feet El meters (Puerto Rico only) b) Top of the next higher floor 26.28 ❑ feet ❑ meters (Puerto Rico only) o to c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) N/A. ® feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 17.51 ® feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) 17.31 ® feet ❑ meters (Puerto Rico only) C" J g) Highest adjacent (finished) grade next to building (HAG) 17.49 ® feet ❑ meters (Puerto Rico only) . h) Lowest adjacent grade at lowest elevation of deck or stairs, including 17.21 ® feet ❑ meters (Puerto Rico only) structural support 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. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes . ❑ No _ Certifier's Name Andrew Snyder License Number LS5639 Title Professional Surveyor & MappeP' Company Name LandTech Survey & Inspections Signature FEMA Form. .881�-31, 1- PLACE byAn PSh1 Snyder,PSM,o=LandTech ou; illundtechsurvey.com, c=US Date 05/03/2012 Telephone (954) 776-6766 Date: 2012.05:0711.09:18-04'00' I 09 See reverse side for continuation. Replaces all previous editions Suite 511 City FL ;a - IMPORTANT: In these spaces, copy the; esponding information from Section A. Building Street Address (including Apt., Unit, Sw«; aVid/or Bldg. No.) or P.O. Route and Box No. 5606 Birch Drive City Fort Pierce State FL ZIP Code 34982 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. Comments C2E Elevation.= A/C Elevation. Finished Floor Elevation is also the New Conc. Slab Elevation. Latitude/Longitude information obtained via Google Earth Signature ,i/l/ y�� Date 05/03/2012 ❑ Check here if attachments 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. El. 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, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ 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 ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑feet ❑meters ❑above or El 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's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ 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 5 and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. 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 bylaw 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-G9) 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: 09. BFE or (in Zone AO) depth of flooding at the building.site: G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum ❑ feet ❑ meters (PR) Datum ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Y ,-a Building Photographs See Instructions for Item A6. Insurance Company Use: Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 5606 Birch Drive City Fort Pierce State FL ZIP Code 34982 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. Front View Rear View Inside Enclosure Southside View