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HomeMy WebLinkAboutElevation certU.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2022 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: JAMES A. & PATRICIA M. WIENCKE A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No, 10751 SOUTH OCEAN DRIVE, NO. A3 City State ZIP Code JENSEN BEACH Florida 34957 A3, Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT A3, VENTURE HARBOR A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27a16'10.51" N Long. 80°12'27.58"1N Horizontal Datum: ❑NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enciosure(s) 240.0 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 2 c) Total net area of flood openings in A8.b 960.0 sq in d) Engineered flood openings? 0 Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage 503.0 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 3 c) Total net area of flood openings in A9.b 600.0 sq in d) Engineered flood openings? ❑x Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community dame & Community Number B2. County Name B3. State UNiNCORP 1 1250285 ST. LUCIE Florida B4. MaplPanel B5. SuOix 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 1201110314 K 02/19/2020 02/19/2020 AE 5.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ 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 0 No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 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: 1 0 —1 S 1 S O u r I--1 0 {_ t2 1 r City State ZIP Code Company NAIC Number �lE"SE;if-u 9fsl�,C_i-i FI. E] 34c)s-7 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 E'i—E5. If the Certfficate 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 mere, 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 l Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions_ corm rage S of 6 BUILDING PHOTOGRAPHS OMB No, 1660-0008 ELEVATION CERTIFICATE See Instructions for Item Afi- Expiration Bate: November 30, 2022 IMPORTANT: in these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildina Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 10751 S❑UTH OCEAN DRIVE #A3 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 toundation with representative examples of the flood openings or vents, as indicated in Section AS. If submiWncd more photographs than will fit on this page, use the Continuation Page. P t Yntito One Photo One Caption FRONT 12 / 2 3/ 2 0 2 0 Clear Photo One 11 Ili. �. / Pnoto Tern Photo Two Caption REAR 12 / 2 3 / 2 0 2 0 Clear Photo Two FEMA Form 086-0-33 (12119) Replaces all previous editions, Form Page b or l5 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buiiding Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No: Policy Number: 10751 SOUTH OCEAN DRIVE #A3 City State ZIP Code Company NAIL Number JENSEN BEACH FLORIDA C] 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 hood openings or vents, as indicated in Section AB. = - F Photo Three Photo Three Caption RIGHT SIDE 12 / 2 3/ 2 0 2 0 Clear Photo Three i Photo Four Photo Four Caption LELi Clear Photo Four FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 6 of 6 DIVISION: 08 00 00---OPENINGS SECTION: 08 95 43---VENTS/FOUNDATION FLOOD VENTS REPORT HOLDER: SMARTVENT PRODUCTS, INC. 430 ANDBRO DRIVE, UNIT 1 PITMAN, NEW JERSEY 08071 EVALUATION SUBJECT: SMART VENT° AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540-520; #1540-521; #1540-510; #1540-511; #1540-570; #1540-574; #1540-524; #1540-514 ICC IGG ICC i�� chg) c. PMIa LISTED Look for the trusted marks of Conformity! 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