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Home My WebLink AboutElevation CertificateU: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. Copv 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: WINDSONG MOBILE VILLAGE A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIL Number. Box No. 3200 SOUTH 7TH. STREET City State ZIP Code FORT PIERCE Florida 34982 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 104, WINDSONG MOBILE VILLAGE A4. Building -Use (e.g., Residential, Non -Residential, Addition, Accessory; etc.) SINGLE FAMILY RESIDENTIAL - A& Latitude/Longitude: Lat. 27.406320 Long.-80.329390' Horizontal Datum: ❑ NAD 1927 [0 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 5 A8. For a building with.a crawispace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0 sq ft_ b) Number of permanent flood openings in the crawispaceYor enclosures) wain 1 Ofgot above adjacent grade. 0 c) Total net area of flood openings in A8.b 0 sq in.: d) Engineered flood openings? El Yes- ..M. N0 A9_ For a building with an attached garage: �•. a) Square footage of attached garage U sq ft .-.• b) Number of permanent flood openings in, the attached garage within '1 0 foot above ad acenf rade x ,. 1 . g 0..', c) Total net area of flood openings ihA9 b 0 sq in d) Engineered flood openings? [] Yes (�No SECTION B :FLOOD;INSURANCE RASE MAp (FIRM),INFORMATION, t ELEVATION CERTIFICATE OMB No.1660-0008 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: 3200 SOUTH 7TH. STREET FORT PIERCE Florida 34982 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, 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: CO BM 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, crawispace, or enclosure floor) 22. 6 feet ❑ meters b) Top of the next higher floor N/A. ❑ :feet ' ❑ meters c) Bottom of the lowest horizontal 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 18, 6 feet meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) (-feet ❑ meters . g) Highest adjacent (finished) grade next to building. (HAG):.: 18 5..` &, feet' : ❑ meters h) Lowest adjacent.grade at lowest elevation of deck or stairs;, including NSA ❑ ;feet ❑ meters structural support : cer►Trnsr n _ e�roa►rvno .eNrr�r�cQ, AI?,�et?L_.`1.1�1'FRT. rGl?T��II'`e?rrnru.. This certification is to be signed and sealed by a land surveyor, engineer, orarchdect authon�ed by law�to certify elevation mfomnafion. 1 certify that the infiormetion on fhts Certificate represents my best of b." to +nterpnefFthe dafa ava►lable 1 r�nderstarid That any_false statement.may be punishable by fine.or imprison►rient underlB U S Code, Seybon `9001 Were latitude and longitude. in Section A provided by a ib6nsetl land surveyor? Yes No ❑ Gheck here rf attachments. Copy all pages.of this Elevation Ce Fh I=VATInN CERTIFICATE. OMB No. 1660-0008 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: 3200 SOUTH 7TH. STREET City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 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, crawispace, 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 El meters El above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. 1 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?- 0 Yes n-No ❑Unknown ':LL The. .label official must.certify;this'infb"rma0i n in Section G. SECTION F =:PROPERTY OWNER (OR OWNER'S REPRESENTAT11i'E) CERTIFICATION 5 The property owner or owners authorized representative who completes Sections A,{B,aand :E for Zone A (without a-FEMA-issued_ oc community -issued BFE) or Zone AO must sign here.The statements m Secfioris A, B, antl E'are correct to the best'of my kritlwledge. Property Owner or Owners Authorized Representative's Name 4 AddressS,tate ZIP -Code _ Flonda Signature Date Telephone Comments Check.here'if.attachmehts. ELEVATION CERTIFICATE OMB No.1660-0008 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: 3200 SOUTH 7TH. STREET City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 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—GI0) 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 ❑ rrieter4 ..Datum G10. Community's design flood elevation: _ ❑feet` ❑'.meters _. Datum Local Official's Name Title;: ' Community Name Telephone Signature `Date' Comments: (including type ofequipment and locafion,per C2(e), applicable)': ❑A Check:here: if attachments. FEMA Form 086-0-33 (7/15) Replaces all-pievious-edifions. Form Page 4 of 6 T BUILDING- PHOTOGRAPHS OMB No. 1660-0008 E10EVATION CERTIFICATE See Instructions for Item A6_ Expiration Date: November 30, 2018 MPORTANT: Inahese spaces, copy the-conresponding information from Section A. FOR INSURANCE COMPANY USE Building Street `Address(including Apt., Unit, Suite, and/orBldg. No.) or P.O. Route and Box No. Policy Number: 3200 SOUTH 7TH. STREET. City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 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. Photo Two Caption 02/1'6/20 FEMA Form 086-0-33 (7115) Replaces aifprevious'editions. Form Page 5 of 6 ' BUILDING PHOTOGRAPHS OMB No.1660-0008 ELEVATION CERTIFICATE IContinuation 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. 3200 SOUTH TTH. STREET City State ZIP Code Company NAIC Number FORT PIERCE - r Florida 34982 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. i Photo:One