HomeMy WebLinkAboutEngineering U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date:November 30,2018
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:
Jeremy Wheeler
A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number:
Box No.
101 EI Mar Drive
City State ZIP Code
Jensen Beach Florida 34957
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
Parcel ID: 4511-110-0005-100-5
A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude: Lat. 27.273054°N Long. -80.209318°W Horizontal Datum: ❑ NAD 1927x❑ 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 1 B
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0.00 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 0 No
A9. For a building with an attached garage:
a) Square footage of attached garage 390.00 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 flood openings in A9.b 0.00 sq in
d) Engineered flood openings? ❑Yes ❑x 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 COUNTY Florida
B4.Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO,use Base Flood Depth)
Revised Date
12111 C:0314 J 02-16-2012 02-16-2012 AE 7
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 B9: ❑ 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(7/15) Replaces all previous editions. Form Page 1 of 6
OMB No. 1660-0008
w ELEVATION CERTIFICATE Expiration Date:November 30,2018
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:
101 EI Mar Drive
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" ❑ Building Under Construction" ❑X 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: SLCBM:AF6571; Elev: 4.07' 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 bottom floor(including basement,crawlspace,or enclosure floor) 7.35 0 feet ❑ meters
b) Top of the next higher floor 17.35 0 feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑ feet ❑meters
d) Attached garage(top of slab) 7.14 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 9.g0 0 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building (LAG) 5.04 ❑X feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 6.86 ❑X feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including ❑ feet ❑ meters
structural support N/A
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.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑X Yes ❑No ❑Check here if attachments.
Certifier's Name License Number Digitally signed by
Andrew Snyder, P.S.M. LS5639 - :.; Andrew Snyder
I DN:c=US,
Titlear 'o=Laridtec
ow�ow 8. t
Surveyor&Mapper " '%4 Aix ging Inc,
- ' L N" ot= 01427E000001
Company Name = ,
Landtec Surveying, Inc. _ 165 9526FC00006E
l� �: n=Andrew
�s ` is_ ;A1;
Address snryder�—_
atgr201.404.2�5"
600 Fairway Drive#101 .
--_�,10:55:37-04'00'•
City State ZIP Code . ` -dobe Acrobat
Deerfield Beach Florida 33441 version:
2019.010.20100
Signature ;� Date Telephone Ext.
03-26-2019 (561)367-3587 19-14
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)
Section C2 E-A/C unit is located on the rear of the building.
Crown of road elevation:4.27'
Latitude and Longitude derived from Google Earth.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6
OMB No. 1660-0008
l ELEVATION CERTIFICATE Expiration Date:November 30,2018
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:
101 EI Mar Drive
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 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 ❑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 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.
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
Florida
Signature Date Telephone
Comments
❑Check here if attachments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6
OMB No. 1660-0008
r ELEVATION CERTIFICATE Expiration Date:November 30,2018
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:
101 EI Mar Drive
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 138-1310. 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 p 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(7/15) 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 30,2018
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:
101 EI Mar Drive
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.
C N t`
77.9 �
y
Photo One
Photo One Caption Front view Clear Photo One
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���. '�1}`�'_ .a�. ..�..r\� ��, ��,.�_. . :..\m�9,�'.._\.�:1V.1 ��`,,t�2`,& �'nsr�,.�•��a
Photo Two
Photo Two Caption Rear view I Clear Photo Two
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS (OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30,2018
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:
101 EI Mar Drive
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.
Photo Three
Photo Three Caption Clear Photo Three
Photo Four
Photo Four Caption { Clear'PhotoFour
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6
' ,NRTMENT OF HOMELAND SECURITY t
Federal Emergency Management Agency
ELEVATION CERTIFICATE
IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 OMB Control Number:1 12008
Expiration:11/31660-0008
1/30/30/2018
Copy all pages of this Elevation Certificate and all attachments for(1)commTinity official,(2)insurance agent/company,and(3)building owner.
SECTION A-PROPERTY INFORMATION FORM INSURANCE COMPANY USE
Al. Building Owner's Name
Jeremy J.Wheeler Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and
Box No. Company NAIC
101 EI Mar Drive Number:
City Jensen Beach State FL Zip Code 34957
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Parcel ID:4511-110-0005-100-5
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude: Lat. 27.2730°N Long.80.2093°W Horizontal Datum: C-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 1A
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) 0 sq ft a)Square footage of attached garage 390 sq ft
b)Number of permanent flood openings in the b)Number of permanent flood openings
crawlspace or enclosure(s)within 1.0 foot in the attached garage within 1.0 foot
above adjacent grade 0 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? (O Yes C No d) Engineered flood openings? Q Yes 0 No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3.State
UNINCORPORATED ST.LUCIE : 120285 ST.LUCIE COUNTY FL
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9.Base Flood Elevation(s)
Revised Date (Zone AO,use base flood
depth
12111C:0314 J 02/16/2012 02/16/2012 AE 7
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69:
O.FIS Profile G FIRM C,Community Determined Cr Other/Source:
B11.Indicate elevation datum used for BFE in Item B9: Q NGVD 1929 O�NAVD 1988 0 Other/Source:
B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? (),Yes t2,No
Designation Date:N/A lG CBRS C-�OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl.Building elevations are based on: 0,Construction Drawings' (-7j)Building Under Construction' tC Finished Construction
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 A7.In Puerto Rico only,enter meters.
A new Elevation Certificate will be required when construction of the building is complete.
Benchmark Utilized: SLCBM:2660; Elev:4.08' Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. O NGVD 1929 G'NAVD 1988
C�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) 7 3 feet meters
b) Top of the next higher floor 17 3 feet meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A Q feet 0 meters
d) Attached garage(top of slab) N/A Q feet a0 meters
e) Lowest elevation of machinery or equipment servicing the building N/A
(Describe type of equipment and location in Comments) (}feet Q meters
f) Lowest adjacent(finished)grade next to building(LAG) 2 0 Q feet Q meters
g) Highest adjacent(finished)grade next to building(HAG) 6 4 (�feet [}meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including
structural support 3 0 (}feet C meters
FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 3 of 15
ELEVATION CERTIFICATE
OMB Control Number:1660-0008
Expiration:11/30/2018
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.
Were latitude and longitude in Section A Digitally
❑Check here if attachments. provided by a licensed land surveyor?
(1 Yes (s',�No signed by
Certifier'sName License Number v° u "'4Sl�i�y Andrew
Andrew Snyder,P.S.M. LS5639 _ 5639. = nyder
Title Company Name $T 3Tare
Surveyor&Mapper Landtec Surveying,Inc. S•- I A 'Date:
Address City State Zip Code 2018.08.07
600 Fairway Dr_v 101 Deerfield Beach FL 133441 1 3:33:2
Signature Date Telephone
06/20/2016 561-367587 -04r00'
Cop sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner.
Comments(including type of equipment and location,per C2(e),if applicable)"
Section C2 E-A/C unit
Latitude and Longitude derived from Google Earth.
This Elevation Certificate is provided for a flood insurance determination and is not to be relied upon for design or
building purposes.
�y
Signature / 4 Date 06120/2016
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,Band 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, ❑above or EJ below the HAG.
or enclosure)is C•feet O meters
b)Top of bottom floor(including basement,crawlspace, 0feet Q meters E]above or E]below the LAG.
or enclosure)is
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 C'1 feet 0 meters ❑above or ❑below the HAG.
E3.Attached garage(top of slab)is
feet ('?.meters E]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? r,Yes G No (C,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(7/15) Replaces all previous editions. Page 4 of 15
OMB Control Number:1660-0008
Expiration:11/30/2018
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: (7,�New Construction C Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)
of the building: fleet 0;meters Datum
G9.BFE or(in Zone AO)depth of flooding at the building
site: ofeet tmeters Datum
G10.Community's design flood elevation: G feet O meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 5 of 15
BUILDING PHOTOGRAPHS
See instructions for Item A6 OMB Control Number:1660-0008
Expiration:11/3012018
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.
101 EI Mar Drive Policy Number:
City State Zip Code Company NAIL
FL 34957
Jensen Beach 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.
Front View
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FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 6 of 15
. `ARTMENT OF HOMELAND SECURITY
Feaeral Emergency Management Agency ,
ELEVATION CERTIFICATE OMB Control Number:1660 0008
IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 Expiration:11/30/2018
Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agenticompany,and(3)building owner.
SECTION A-PROPERTY INFORMATION FORM INSURANCE COMPANY USE
Al. Building Owner's Name
Jeremy J.Wheeler Policy Number.
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and
Box No. Company NAIC
101 EI Mar Drive Number.
City Jensen Beach State FIL zip Code 34957
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Parcel ID:4511-110-0005-100-5
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude: Lat. 27.2730°N Long.80.2093°W Horizontal Datum: C NAD 1927 ry 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 1A
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) 1921 sq ft a)Square footage of attached garage 0 sq ft
b)Number of permanent flood openings in the b)Number of permanent flood openings \
crawlspace or enclosure(s)within 1.0 foot in the attached garage within 1.0 foot
above adjacent grade 0 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 R No d) Engineered flood openings? r Yes ( No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3.State
UNINCORPORATED ST.LUCIE : 120285 ST.LUCIE COUNTY FL
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9.Base Flood Elevation(s)
Revised Date (Zone AO,use base flood
depth
12111C:0314 J 02/16/2012 02/1612012 AE 7
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9:
ri FIS Profile G FIRM t✓Community Determined C Other/Source:
B11.Indicate elevation datum used for BFE in Item B9: (1 NGVD 1929 O NAVD 1988 C Other/Source:
B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? (�;Yes 6_1 No
Designation Date:N/A r CBRS r,OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl.Building elevations are based on: r-Construction Drawings' 0 Building Under Construction' (y Finished Construction
C2.Elevations -Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARAE,AR/Al-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.
A new Elevation Certificate will be required when construction of the building is complete.
Benchmark Utilized: SLCBM:2660; Elev:4.08' Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. NGVD 1929 r•NAVD 1988
0 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) 7 3 G,feet ri meters
b) Top of the next higher floor 17 3 (V feet meters
c) Bottom of the lowest horizontal structural member(V Zones only) NIA 0 feet 0 meters
d) Attached garage(top of slab) NIA G feet G meters
e) Lowest elevation of machinery or equipment servicing the building NIA
(Describe type of equipment and location in Comments) )feet n meters
0 Lowest adjacent(finished)grade next to building(LAG) 2 0 Gj feet r meters
g) Highest adjacent(finished)grade next to building(HAG) 6 4 (j feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including 3 0
structural support G feet 0 meters
FEMA Form 086-0-33(7115) Replaces all previous editions. Page 3 of 15
y.
ELEVATION CERTIFICATE _
} OMB Control Number.1660-0008
Expiration:11/30/2018
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.1 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
❑Check here if attachments. provided by a licensed land surveyor? i i Digitally signed by
r Yes O No 'J Andrew Snyder
Certifier's Name License Number f DN:cn=Andrew
Andrew Snyder,P.S.M. LS5639 J Snyder,o=Landtec
Title Company Name a,% MU ,` Surveying,Inc.,oU,
���� =:email=asnyder@la
Surveyor&Mapper Landtec Surveying,Inc. a iElndtecsurvey.com,
Address City State I Zip Code i �,.--c=US
600 FairwayDrive#101 Deerfield Beach FL 3341 --r
Date:2016.06.28
Signature Date Telephone 12:27.42-04'00'
06/20/2016 561-367-3587
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner.
Comments(including type of equipment and location,per C2(e),if applicable)"
Section C2 E-AIC unit
Latitude and Longitude derived from Google Earth.
Signature _ Date 06/20/2016
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).
a)Top of bottom floor(including basement,crawlspace, `'j feet 0 meters ❑above or ❑below the HAG.
or enclosure)is '
b)Top of bottom floor(including basement,crawlspace, (-,feet Gmeters E]above or r-1below the LAG.
or enclosure)is
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 G feet G meters ❑above or ❑below the HAG.
E3.Attached garage(top of slab)is ()feet G meters ❑above or ❑below the HAG.
E4.Top of platform of machinery and/or equipment
servicing the building is 0 feet (:a 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 (7),No C,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(7/15) Replaces all previous editions. Page 4 of 15
OMB Control Number.1660-0008
Expiration:11/3012018
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 G4-1310)is provided for community floodplain management purposes.
G4. Permit Number G5.Date Permit Issued G6.Date Certificate of Compliance/Occupancy Issued
137. This permit has been issued for. ( 'New Construction (2 Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)
of the building: ( feet (j meters Datum
G9.BFE or(in Zone AO)depth of flooding at the building
site: r feet 0 meters Datum
G10.Community's design flood elevation: - feet C;meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
F]Check here if attachments.
FEMA Form 086-0-33(7115) Replaces all previous editions. Page 5 of 15
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
POST CONSTRUCTION ELEVATION CERTIFICATEIFLOODPROO FING CERTIFICATE
COMMUNITY NUMBER
St. Lucie Co., Fl. (UNINCORPORATED AREA0 120285
INSTRUCTIONS
The registered professional engineer, architect, surveyor or community permit official completes Section I below.
Section 13 may-be Completed by any of the professionals listed at the beginniiig of Section U,*or by at'similarly quail fied
local'permit official. Print or type the information on this form.This form Is to be used for now(POST-FIRM)construction
and for substantial improvements to,existing structures In Zones At-A30,'Ali and V1430 and existing (PRE-FIRM)
buildings to be rated under POST-FIRM rules,and rates.
SECTION I
(TO BE COMPLETE P BY COMMUNITY PERMIT OFFICIAL)
1OPERTY ADDRESS(or lot and block numbers It address is unarallablal
LOI El Mar Drive-Beach Club Colony See I (NAME: Rita H. Knoeller BPN (51461
A Mk�PE CH PROPERTY 13 LO ED
,:PANEL ON WHICH PROPERTY IS LOCATED FIA MAP ZONIN WHI
313 A10'
&MAP EFFECTIVE DATE BASE FLRP.*"ATION AT THE PROPOSED SITE
January 5. 1984 .l,8 :
[ART OF CONSTRUCTION GATE Name and Title PHONE(with Area Code)
12/89 Terry L. Virta -Community Development Director 1(407) 468-1553
)DRESS
_2300—Yirginia Ave., Ft....Pierce.. t1. 33450
December 15, 1989
_ SECTION 11
INSTRUCTIONS
Complete only the Elevation Certification unless the building h&3 been floodproofed at least to the base flood
elevation. It floodproofing is used, complete only the Floodprooling Certification. The Elevation Certification maybe
completed by a registered professional engineer,architect,or surveyor. The Floodproofing Certification may only be
completed by a registered professional engineer or architect.
ELEVATION CERTIFICATION
4
I certify that the building
operty location describbd above has the lowest floor at an elevation of
feet,NGVD(mean sea level).
FLOODPROOFING CERTIFICATION
I certify to the best of my knowledge,information,and belief;that"the structure Is designed so that the structir is'
watertight to an elevation of . . —feet NGVD (mean sea IsveQ, with walls substantially
impermeable to the passage of water and structural Components having the capability of resisting hydrostatic and
hydrodynamic loads and effects of buoyancy that would be Caused by:the flood depths,pressures,velocities, impact
and uplift forces associated With the base flood.
In the event of flooding,will,this degree of floodproofing be achieved with human intervention?*
Will the structure be occupied as a residence?
It the answer to both questions is Yes the.floodproofing cannot.be credited for rating purposes.and the elevation
certification must be completed instead.
*Floodprooted with human Intervention means that water will artier the structure when goods up to the base flood
level occur, unless measures are taken prior to the flood to prevent entry of water (e.g. bolting metal shields over
doors and windows).
ERTIFIER'S NAME Amx SEAL on,wRrrE PROFESSIONAL
LICENSE No.
rTLE
DDRESS
The insurance agent attaches the second copy of the completed torn to the flood insurar4a policy application
for new(POST-FIRM)Construction,ci substantial improvements. Be sure.thot the second copy Is cofflod.