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HomeMy WebLinkAboutElevation CertificateU.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MAPJAGEMENT AGENCY ELEVATION CERTIFICATE` OMB No. 1660-0008 National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name JOSE & MILAGROS MONTES Policy Number: A2. Build[ Street tr WATERSONGt1 AY Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: City FORT PIERCE State FL ZIP Code 34949 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 58, WATERSONG PUD, PLAT NO. 1 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. ►y 27 93' 70 92" Long, W 80 15' 3520" 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 8 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) 400 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace 3 b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade 2 c) Total net area of flood openings in A8.b 432 sq in c) Total net area of flood openings in A9.b 439 sq in d) Engineered flood openings? N Yes ❑ No d) Engineered flood openings? N Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name B3. State UNINCORPORATED 120285 ST. LUCIE I FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AD, use base flood depth) 12111 C 0194 J 02/16/2012 02/16/2012 AE 6' & 7' B10.Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ AS Profile N FIRM ❑ Community Determined ❑ Other/Source: B11.Indicate elevation datum used for BFE in Item 89: ❑NGVD 1929 N NAVD 1988 ❑ Other/Source: B12.Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? N Yes ❑ No Designation Date: _ 9 / 15 / 1988 ® CBRS ❑ OPA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* N 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, 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: 94 77 A 16 FLDT Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) .Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) .Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Check the measurement used. 6 2 ® feet ❑ meters 18 . 9 N feet ❑ meters N/A , N feet ❑ meters 6 _2 N feet ❑ meters 9 . 6 N feet ❑ meters 5 7 ® feet ❑ meters 6 6 N feet ❑ meters 6 0 N feet ❑ meters 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. 1 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. [E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a E] Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifier's'Name License Number CHARLES ARNOLD, PSM LS 4971 Title Company Name VICE PRESIDENT ARNOLD SURVEYING, INC. Address City State ZIP Code 4888 N. KINGS IGHVI Y #43E FORT PIERCE FL 34951 Signature Date Telephone 10/25/2016 (772) 460-8211 PEN� FEMA Form 086-0-33 (Revised 7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 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: 4920 WATERSONG WAY City State ZIP Code I Company NAIC Number: I FORT PIERCE FL 34949 SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments ELEVATION OF THE A/C WAS USED FOR THE LOWEST ELEVATION OF MACHINERY LATITUDE / LONGITUDE WAS OBTAINED USING A HANDHELD GPS UNIT Signature z� oo"7 Date 10/25/2016 SECTION E — BUILDING ELEVATION IWORMATION (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 8-9 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 Signature Date Telephone Comments ❑ Check here if attachments. 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: ❑ 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 ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. 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: 4920 WATERSONG WAY City State ZIP Code Company NAIC Number: FORT PIERCE FL 34949 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 - PHOTO TAKEN SEPTEMBER 13.2016 i --71 REAR VIEW - PHOTO TAKEN SEPTEMBER 13.2016 FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS Continuation Page 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: 4920 WATERSONG WAY City State ZIP Code Company NAIC Number,. FORT PIERCE FL 34949 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. LEFT/NORTH SIDE VIEW - PHOTO TAKEN SEPTEMBER 13.2016 RIGHT/SOUTH SIDE VIEW - PHOTO TAKEN SEPTEMBER 13.2016 FEMA Form 08&0-33 (Revised 7/12) Replaces all previous editions. l r U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date: July 31, 2015 National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name JOSE & MILAGROS MONTES Policy Number: A2. Build[ 20 WAddress G nVApt , Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: City FORT PIERCE State FL ZIP Code 34949 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 58, WATERSONG PUD, PLAT NO. 1 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. N 27 93' 9n 0" Long. W 80 15' 35.20" Horizontal Datum: ❑ NAD 1927 ❑IC 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 R 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) N/A sq ft a) Square footage of attached garage 480 sq ft b) Number of permanent flood openings in the crawlspace N/A b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade 2 c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b .989 sq in d) Engineered flood openings? ❑ Yes N No d) Engineered flood openings? N Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number B2. County Name B3. State UNINCORPORATED 120285 ST. LUCIE I FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 12111 C 0194 1 02/16/2012 02/16/2012 AE 6' & 7' B10.Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9: ❑ RS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11.Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 N NAVD 1988 '❑ Other/Source: 612.Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ® Yes ❑ No Designation Date: 9 / 15 / 1988 N CBRS ❑ OPA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* N Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones A1—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: 94 77 A 16 FLDT Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 N 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) 8 4 N feet ❑ meters b) Top of the next higher floor 18 9 N feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) 17 . 0 N feet ❑ meters d) Attached garage (top of slab) 6 _2 N feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 9 6 N feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5 7 N feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 6 6 N feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck,.or'stairs, including 6 0 N feet ❑ meters structural support 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. 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 0 Check here if attachments. licensed land surveyor? ® Yes ❑ No 'If RE FEMA Form 086-0-33 (Revised 7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 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: 4920 WATERSONG WAY City State ZIP Code Company NAIC Number: FORT PIERCE FL 34949 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A5 WAS OBTAINED USING A HANDHELD GPS UNIT; A9C IS ACTUAL OPEN SIZE: SEE ICC FOR ENG DESIGN SPECS OF ENG OPENINGS; C2A REFERS 10 IS I Ft:00K LIVING AREA ELEV; C21:3 REFERS 10 2ND FLOOR LIVING AREA ELEV; C2C REQUESTED BY LOCAL INSPECTOR: HOUSE IS NOT IN V ZONE; C2E REFERS TO A/C ELEV; Signature Date 11/15/2016 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 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, 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 8-9 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 Signature Date Telephone Comments ❑ Check here if attachments. 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 I G5. Date Permit Issued I 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 ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. 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: 4920 WATERSONG WAY City State ZIP Code Company NAIC Number: FORT PIERCE FL 34949 If using the Elevation Certificate to obtain NAP 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. ALL PHOTOS ON THIS ELEVATION CERTIFICATE TAKEN NOVEMBER 7, 2016 FRONT VIEW GARAGE SHOWING SOLID WALLS I - - I, I REAR VIEW PATIO VIEW FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS Continuation Page 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: 4920 WATERSONG WAY City State ZIP Code Company NAIC Number: FORT PIERCE FL 34949 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. ALL PHOTOS ON THIS ELEVATION CERTIFICATE TAKEN NOVEMBER 7, 2016 LEFT/NORTH SIDE VIEW RIGHT/SOUTH SIDE VIEW FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY ,ELEVATION CERTIFICATE ` OMB No. 1660-0008 National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building owner's Name JOSE & MILAGROS MONTES Policy Number: A2. Buildln Street Add^e's�ncludin,AQt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: City FORT PIERCE state FL ZIP Code 34949 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 58, WATERSONG PUD, PLAT NO. 1 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. N 27 23' 9n A2" Long. W 80 15' 35.20" 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. A7. Building Diagram Number 6 AS. 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) N/A sq ft a) Square footage of attached garage 480 sq ft b) Number of permanent flood openings in the crawlspace NIA b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade 3 c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 512 sq in d) Engineered flood openings? ❑ Yes N No d) Engineered flood openings? N Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number rUNINFWRP-ORATED- B2. County Name B3. State 120285= ST. LUCIE I FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) 89. Base Flood Elevation(s) (Zone Revised Date AD, use base flood depth) 12111 C 0194 1 02/16/2012 02/16/2012 AE 6' & 7' B10.Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 IR NAVD 1988 ❑ Other/Source: B12.Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? N Yes ❑ No Designation Date: 9 / 15 / 1988 ® CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* IR 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: 94 77 A 16 FLDT 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. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Check the measurement used. 8 .4 N feet ❑ meters 18 , 9 N feet ❑ meters 17 , 0 N feet ❑ meters 6 2 N feet ❑ meters 9 , 6 N feet ❑ meters 5 . 7 N feet ❑ meters 6 , 6 N feet ❑ meters 6 , 0 N feet ❑ meters 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. I] Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 0 Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifier's Name License Number CHARLES ARNOLD, PSM LS 4971 Title VICE PRESIDENT Hoaress City State ZIP Code 4888 N. KINGS HIGHWAY 425 FORT PIERCE FL 34951 Date Telephone 12/01/2016 (772) 460-8211 FEMA Form 086.0-33 (Revised 7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 4920 WATERSONG WAY City State ZIP Code FORT PIERCE FL 34949 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A5 WAS OBTAINED USING A HANDHELD GPS UNIT; A9C CONTAINS TOTAL FOR ENGINEERED AND YES AND NO ARE CHECKED; C2C REQUESTED BY LOCAL INSPECTOR: HOUSE IS NOT IN V ZONE; C2E REFERS TO A/C ELEV 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 8-9 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 E] 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 Signature Date Telephone Comments ❑ Check here if attachments. 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 community4ssued BFE) or Zone AO. G3. ❑ The following information (Items G4-G10) is provided for community floodplaln management purposes. G4. Permit Number G5. Date Permit Issued 7 6. 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 ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. 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: 4920 WATERSONG WAY City State ZIP Code CompanyNA1C Number: FORT PIERCE FL 34949 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. ALL PHOTOS ON THIS ELEVATION CERTIFICATE TAKEN NOVEMBER 7, 2016 FRONT VIEW REAR VIEW 11 4i,-Q E:.. I UT '---' � l GARAGE SHOWING SOLID WALLS PATIO VIEW turn iL .. 'k'.:. FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS Continuation Page 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: 4920 WATERSONG WAY City State ZIP Code Company NAIC Number: FORT PIERCE FL 34949 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. ALL PHOTOS ON THIS ELEVATION CERTIFICATE TAKEN NOVEMBER 7, 2016 LEFT/NORTH SIDE VIEW RIGHT/SOUTH SIDE VIEW FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions.