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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 14. 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. WINDSONG MOBILE VILLAGE A2. Building Street Address (including Apt-, Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC 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 76, WINDSONG MOBILE VILLAGE A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc-) SINGLE FAMILY RESIDENTIAL A5. Latitude/Longitude: Lat. 27.406320 Long.-80.329390 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 5 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0 sq #t b) Number of permanent flood openings in the crawlspace'or enclosun3(s) within 1.O.;fooYabove adjacent grade,' 0 c) Total net area of flood openings in A8.b 0 sq in = d) Engineered flood openings? ❑ Yes ER No A9. For a building with an attached garage. - a) Square footage of.attached garage 0 b) Number of.permanent flood openings in the attached garage wdhm `1 0 foot above adfacenf grade 0 c) Total net area -of flood openings inA9.b p d) Engineered flood openings? 0 Yes:: --No SECTION B fLOOD:INSURANCE RATE MAP (FIRM) INFORMATION. B1. NFIP Community Name &Community Number : 62 County Name ' ' 63 State SM LU.CIE COUNTY 120285 . , � ST LUCIE Flon B4. Map/Panel -B5 Suffix B6 FIRMIndee B7 FIRM panel ` B8 FloodZone(s} 69 Base Flood:Eleva6on(s) Number Date_:` :.Effective/ (Zone AO use Base ,Revised Date FloodDepttS} 12111 CO187 J. 02/16/2015 02116/2012 1310. Indicate the source of the Base Flood=Elevation (BFE) data or base flootl tlepth entered 130. ;., FIS Profile []'FIRM . Comi't bi Determined.: Other/Source _. ❑❑ �Y a.. B11. Indicate'elevat pn:datum used -for BFE;in Item:i39 ❑ NGVD 1929 NAVD 1988 ; ❑Other/Source B12- Is the'building_located:in:a'Coastal Bamer Resouices.System-(CBRS).area orOther rinse Protected Area (QPA)?: ❑Yes No .. -. Designation -Date 0' 18/2019 -. [] CBRS ,[] OPA FEMA Form 086-0-33 (7/15) Replaces al I�previouseditions. Form Page 1 of 6 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 C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Pinished 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, ARIA, 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, entermeters.. Benchmark Utilized: CO BM Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ja NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BEE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 20. 8 ® 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 El meters d) Attached garage (top of slab) N/A.. feet . ❑ meters e) Lowest elevation of machinery or equipment servicing.,the building 17- 5 E feet ❑ meters (Describe type of equipment and location in Comments) . f) Lowest adjacent (finished). grade next to,building (LAG) 17: 1 5d. feet ❑ .meters g) Highest adjacent (finished) grade next to building :(HAG) 17 3= ® feet ❑meters - ❑ h Lowest adjacent:grade at lowest elevation of. deck,or stairs;; includ n '1'1 A meters 1 9 .:❑ • .9 .feet' structural,support - SECTION D = SURVEYOR, ENGINEER, 'ICARCHITECT CERTIFtCAT10N " This certification is to be signed -and sealed by a lani surveyor, engineer, or arcFiltect authorized by law to certify elevation information. I certify that the informatroh ;on this Certificate represents m}cbest ®f%rts to nt®rpret the data available I understand fh_at any false statement maybe punishable by;frne or imprisonment under 18 U S Coda, Section_ 0 Were latitude and longitude in Section A provided: by -a licensed land surveyor? Yes ❑ No , - ❑`Check :here, if attachments. - = Certifier's Name ce LnseSNumber MARK W. TEEPE 4811 Title P.S.M. Company Name .: CORNERSTONE SURVEYING . Address 325 SW -SOUTH QUICK:CIRCLE i City State ZIP Code PORT ST..LUCIE Florida,. 34953- `5.: Signature Date Telephone 7724182376 Copy all pages of. this Elevation Cer6fi, v e antl :all attachments for,(1) oommumty official, (2) insurance agent/Whibany, and (3) building owner.. Comments iricludm �. a of=e ui merit and ;location;: per C2 e , d applicable 9 tYP. q p (� ) A/C.UNIT This residence.is 18f-above:,crown of road FFMA Fnrm nAFLn_,,v3 !7ii_m 17anlnnncC2211_krMu" io�._A:tinna FnmiPAna 2 Af R ELEVATION CERTIFICATE t OMB No. 1660-0008 Expiration Dater 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 INFORMATIOW(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 COMA 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. Provide elevation informa$on 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 ❑ ❑ below the HAG. ❑ meters above or 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 E J above or ❑ below the HAG. E3. Attached garage (top of slab) is . ' ❑ feet . El meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is " ❑ feet ❑ meters 0 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 flood lain management ordinance? p g ❑Yes ❑ No=; ❑ lJnknown `The local offic ahmust certify-ahis.information.in Section G. SECTION F PROPERTY OWNER (OR OWNER'S REPRESENTATIVE),CERTIFICAt10N= , ' The property owner or owners authorized representative who. completes Sections A ; B, and E for Zone A (�nnthout a FEMA4stued or community-issued:BFE) or Zone AO.must,sign ,here <The statements'm Sections A, ;B, and E'are correct foahe best•of my, knowledge. Property Owner or Owners Authorized Representative's Name _ Address City ° ; ;; State Code ZIP ELEVATION CERTIFICATE OMB No.1660-0008 Fxnirafinn notw AlnvnmhcrAn onin 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. 3206 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 floodpiain 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. Communiity's design flood elevation: ❑ feet 11 meters . Datum - Local Official's Name Titie, Community Name Telephone Signature Date' Comments includin . A e of 'e: ui rent and location;;per C2 , if a ` livable ( 9 tyP. q P - Checkhere0attachments. FEMA Form 086-0-33 (7/15) Replaces all previous.editions. Form Page 4 of 6 ELEVATION CERTIFICATE i BUILDING PHOTOGRAPHS, See Instructions for Item A6. OMB No. 166"008 Exniratinn r)atp- Nnvamhor nn 9nin 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 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. •CIVIA roan Uts0-U-33 (//10) 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: 3200 SOUTH 7TH. STREET City . State ZIP Code Company NAIC Number FORT PIERCE T 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. Pho6,one `- Photo One Caption _. . r ,Photo T,wo . Photo. Two. Caption 7=- FEMA Form 086-0-33 (7/15) Replaces all previous edittoris. Form Page 6 of 6