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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 NationarFlooa Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certficate and all attachments for (1) community official, (2) insurance aaent/comoanv and'(31 buildina 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. 3260 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 90, WINDSONG MOBILE VILLAGE A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory`, etc.) SINGLE. FAMILY RESIDENTIAL A5. Latitudell-ongitude: 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 ft •. b) Number of permanent flood openings in the. crawls- or:enclosu e(s) v0 110 io6tabbve.adjacent,grade. 0 . c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? 0 Yes-. R No _• A9. For a building with an attached garage: a) Square footage of attached garage- p . sy ftj b) Number of permanent flood openings m the: attached garage withirt1 0 faot above'adlacent,grade 0. . r. c) Total met area of flood openings, in A9.b , . 0 sq in - d) Engineered,flood.openings? ❑Yes No ,:.-. SECTION B .;FLOOD INSURANCE RATE MAP (FIRM] INFORMATION_ B1. NFIP Communi Name 8 Commune Number tY ty ST. LUCIE COUNTY ' 1 -0285 ST. LUCIE. Flora la 64: Map/Ranel $5 Suffix B6 FIRM Index` B7 •FIRM Fanel B8 ~Flood Zones ) 39 Base Flood Elevations) Number Dater Effective/ _Revis'ed Date;, (Zone AO use Base Flopi Depth) ' 1211.1 C0187 J 02/16/2015 .' 0211.6/2 012 "X" N/A 610--l6dicate the -source of the Bese Flood:Elii on (BFE) data or,base flood depth entered,�n Item 89 ❑•FIS Proflle ;❑ :FIRM ❑-Community Determined:: ❑Other/Source v ,.L,....... B1'1. Indicate elevation datum used.for BFE,in Item-B9 ❑ 1VGVD 1929 NAVD 1988 ❑Other/Source N/A B12..Is the buildmg,aocated in a .Coastal Bamer Resources.System (CBRS), area or Otherwise Protected Area (OPA)? ❑ Yes ;. DesignatlonDate 09118/2019- ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous,editions. 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* ® 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, VI-V30, V (with BFE), AR, ARIA, AR/AE, AR/AIIA30, 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 WE. Check themeasurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 21. 4 2 feet 0 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 equipmentservicing the building.. 17. 2 2, feet ❑ meters (Describe type of.equipment and location in Comments) f) Lowest adjacent (finished). grade next to building .(LAG) 16;. 9-. 2--feet ❑ meters g) Highest adjacent (finished) grade next to building .(HAG) .. 17. ` J. feet ❑ 'meters h) Lowest adjacent grade at lowest elevation of deck or stairs; mciuding .N/A.. feet ❑ .meters structural support SECTION D -� SUR1/EYOR, ENGINEER, OR ARCHITECT CERtIFICATION This certification is to be signed and sealed; by a land surveyors engineer`, or architect authorized by taw to :certify elevation mformation.' I certify that the informationon this Certficat a represents,ltiy_ Wiest efi`orts fo rnterpret the tlata available 1 tintlerstai►tl that;any fake; : " statement maybe punishable by fine orimpnsonment under 98 U $: Cotle,='Sectror 1Q01 Were latitude and longitude in Section A provided by a licensetl land surveyor? Yes ❑ No ❑:`Check_here'�f,attactiments. Certifier's Name Licens% umber - MARK W. TEEPE 4811 - Title P.S.M. Company Name CORNERSTONE SURVEYING �\ . Address 325 SWSOUTH-QUICK CIRCLE city- State: ZIP Code;. PORT ST. LUCIE Florida,, 34953 ; .�P Sigma Date Telephone �. t??J14/2020 77241$2376 Copy all'pages of thisElevation C rtificate andall attachments for (1) commun�tyr official, (2) insurance agent/companyand (3) buildmg owner. Comments (including type of equipment andiocatlon er C2 e , d a liable P O pP ) A/C UNIT This residence is 4.3' above.crown of road - FEMA Form 086-0-33 (7115) Replaces all,previous-editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30; 2018 IIWPORTANT: 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 INFORMAT16N.(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 El-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, crawlspace, or enclosure) is Elfeet Elmeters Elabove or Elbelow 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 - El 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 [J. No ❑Unknown:. Tfie IQcal official must certify this: information in Section G. SECTION F - PROPERTY OWNER(OR OWNER'S REPRESENTATNE) CERTIFICATION. ' . .. The property owner or owners authorized representative who completes Sections A; Band`iE,for Zone A (without a FEMA issued or community -issued i3FE)'or Zone AO must sign here The statements m Sections A, B, and E are correct to the best of myknowledg' Property Owner or Owner's -Authorized Representative's Name Address City, State ZIP Code w, 1 Florida Signature Date Telephone Comments Check=here.if'attacFiments. FEMA Form:086-0-33 (7/15) Replaces all previous editions. Form Paqe 3 of 6 ELEVATION CERTIFICATE OMB No.1660-0008 Exniratinn Datp- Nnvemhwr3n 9n1R IMPORTANT: In these spaces, copy thecorresponding 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—G10) is provided for community floodplain management purposes. G4. • Permit Number . G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued . W. 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 ❑;rrieters Datum Local Offiicial's Name Title Community Name Telephone ``. Signature Date' Comments (including type. -of equipment and; locati;=;pe onr C2(e), fi appl�cablej " Check he'r6ff-attachments. FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Pace 4 of 6 ELIEVATION CERTIFICATE BUILDING: PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 Exoiration Date- Novemher 30_ W11I 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. 9 N� Photo;one BUILDING PHOTOGRAPHS OMB No.1660-0008 ELAVATION CERTIFICATE Continuation Paqe Exoiration Date- Novemher 3n- 201 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 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. Photo;Orie ;� avin rVnn v0v-v--'0 tii 10/ Keplaces.aq:preVlous eamons_ Corm Page 6 of I