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Home My WebLink AboutElevation Certs 'U.S. DEPARTMENT OF HOMELAND OURITY � 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. 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: LOUIS SIMMERMACHER A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number: Box No. 7912 SOUTH OCEAN DRIVE City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description,etc.) LOT 4, DIAMOND SANDS PLAT NO.2 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.N 27 19 13.37 Long.W -80 13 36.25 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 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 1,895 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑Yes X❑ No A9. For a building with an attached garage: a) Square footage of attached garage 0 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes ❑X No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2. County Name B3. State ST LUCIE COUNTY, UNINCORPORATED 120285 SAINT LUCIE Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12111 C 0303 J 02/16/2012 02/16/2012 AE 7 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139: ❑ 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)? X❑Yes ❑ No Designation Date: 10/1/1983 X❑ CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 • 0' OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* 0 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: FDOT BM#10 Vertical Datum:NAVD 1988 Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ❑X 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. 1 ❑X feet ❑ meters b) Top of the next higher floor 20. 9 ❑X feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) 16 1 ❑X feet ❑meters d) Attached garage(top of slab) NSA. 0 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 11. 2 ❑x feet ❑ meters (Describe type of equipment and location in Comments) 0 Lowest adjacent(finished)grade next to building(LAG) 6. 5 ❑X feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 7. 9 ❑X feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8. 5 ❑X 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. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. /understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑X Yes ❑No ❑Check here if attachments. Certifier's Name License Number CHARLES ARNOLD, PSM LS 4971 Title VICE PRESIDENT Company Name ac — ARNOLD SURVEYING, INC. _ _eal . Address H r ^ 4888 N KINGS HIGHWAY#425 City State ZIP Code FORT PIERCE Florida 34951 Signature Date Telephone 07/12/2018 (772)460-8211 Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company,and(3)building owner. Comments(including type of equipment and location, per C2(e), if applicable) ITEM A5 WAS OBTAINED USING A HANDHELD DEVICE; ITEM C2C REQUESTED BY LOCAL INSPECTOR: HOUSE IS NOT IN V ZONE; ITEM C2E REFERS TO A/C ELEV; PAGES 1,2,5&6 COMPLETED BY SURVEYOR; PAGES 3&4 LEFT BLANK INTENTIONALLY&IS NOT CERTIFED BY SURVEYOR FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 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 budding 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 owners authorized representative ive 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. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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: E] 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(including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 0 BUILDING PHOTOGRAPHS • OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 7912 SOUTH OCEAN DRIVE 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 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. t � A Photo One Photo One Caption FRONT VIEW-PHOTO TAKEN JULY 17,2018 11111�II��111111111111►=':�� _� IL� IIIII►=:��._ ' A p a Photo Two Photo Two Caption REAR VIEW-PHOTO TAKEN JULY 17,2018 FEMA Form 086-0-33(7/15) 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number • JENSEN BEACH Florida 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 flood openings or vents, as indicated in Section A8. t ■ 4 Y t y. a 7 , xri^t"1fiw `" tro`{'�=,cam `wa'aks '�'•, n'c•,y� �w ' L70 r Photo One Photo One Caption RIGHT VIEW-PHOTO TAKEN JULY 17, 2018 p 1t f Q 7. r �I T.. Photo Two Photo Two Caption LEFT VIEW-PHOTO TAKEN JULY 17,2018 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 U.S. DEPARTMENT OF HOMELAND&RITY • 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. Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agerit/company,and(3)building owner. SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: LOUIS SIMMERMACHER A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number. 7912 SOUTH OCEAN DRIVE City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) LOT 4, DIAMOND SANDS PLAT NO.2 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.N 27 19 13.37 Long.W -80 13 36.25 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 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 1,895 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑Yes ❑x No A9. For a building with an attached garage: a) Square footage of attached garage 0 sq It b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes 0 No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3. State ST LUCIE COUNTY, UNINCORPORATED 120285 SAINT LUCIE Florida B4. Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9.Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12111 C 0303 J 02/16/2012 02/16/2012 AE 7 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139: ❑ FIS Profile Z FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ❑ No Designation Date: 10/1/1983 0 CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 I 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. 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x 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: FDOT BM#10 Vertical Datum:NAVD 1988 Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 0 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. 1 Z feet ❑ meters b) Top of the next higher floor 20 9 ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) 16 1 ❑x feet ❑meters d) Attached garage(top of slab) NSA. 0 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 11 2 0 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 6. 5 0 feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 7 9 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8. 5 0 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. 1 certify that the information on this Certiricate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑No ❑Check here if attachments. Certifier's Name License Number =�- CHARLES ARNOLD, PSM LS 4971 Title VICE PRESIDENT : Company Name ' lice A¢ ARNOLD SURVEYING, INC.AddressHr — 4888 N KINGS HIGHWAY#425 City State ZIP Code FORT PIERCE Florida 34951 Signature Date Telephone 07/12/2018 (772)460-8211 Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(including type of equipment and location,per C2(e),if applicable) ITEM A5 WAS OBTAINED USING A HANDHELD DEVICE; ITEM C2C REQUESTED BY LOCAL INSPECTOR: HOUSE IS NOT IN V ZONE; ITEM C2E REFERS TO A/C ELEV; PAGES 1,2,5&6 COMPLETED BY SURVEYOR; PAGES 3&4 LEFT BLANK INTENTIONALLY&IS NOT CERTIFED BY SURVEYOR FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 • • OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 El—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 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. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 • • OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30,2018 IMPORTANT:In these spaces,co the corresponding information from Section A. PY P 9 FOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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(including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 7912 SOUTH OCEAN DRIVE 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 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. 000 t � Photo One Photo One Caption FRONT VIEW-PHOTO TAKEN JULY 6,2018 f n a Photo Two Photo Two Caption REAR VIEW-PHOTO TAKEN JULY 6,2018 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 I BUILDING PHOTOGRAPHS 10 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 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 flood openings or vents,as indicated in Section A8. 1 Photo One Photo One Caption RIGHT VIEW-PHOTO TAKEN JULY 6,2018 i ICI Photo Two Photo Two Caption LEFT VIEW-PHOTO TAKEN JULY 6,2018 FEMA Form OB6-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 7912 SOUTH OCEAN DRIVE 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 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. F11 j KIM II� { 4 G Photo One Photo One Caption FRONT VIEW-PHOTO TAKEN JULY 17,2018 4 �fl�'?� Allllllllin►►��I�I@f' II��I�=�IIIU��IIII��I� I�IIII __ I. J11, IIIIIII��III.�� r a _ "1 t1. a .A Photo Two Photo Two Caption REAR VIEW-PHOTO TAKEN JULY 17, 2018 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 l 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 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 flood openings or vents, as indicated in Section A8. a } rr r r �..6�,,." r- x, d��"'•„-t"+c:�,^4s„,§L�4a d� �ea ,��"a- 5?�µ n "h yt�v YA �t�S kt`'�` �.��c�'"N ifti�y,�5e,7.�� a..,,�j .n�;z✓` •xY ,mwt as.nr �9•- �� s• �'..o.....s x a�3sm. '+•t'tr`n`Ssx s�`F�..,•r✓ �: e' t ,=e� `�< � ,+.Lt r { ti Photo One Photo One Caption RIGHT VIEW-PHOTO TAKEN JULY 17,2018 ! t- 12, IT r ,i M.. Photo Two Photo Two Caption LEFT VIEW-PHOTO TAKEN JULY 17,2018 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 II'U.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. 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: LOUIS SINIMERMACHER A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number. Box No. 7912 SOUTH OCEAN DRIVE City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description, etc.) LOT 4, DIAMOND SANDS PLAT NO.2 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.N27.320286 Long.W80.226529 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 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 3,603 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑Yes ❑x No A9. For a building with an attached garage: a) Square footage of attached garage 0 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes ❑x No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2. County Name B3. State UNINCORPORATED 120285 SAINT LUCIE Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12111 C 0303 J 02/16/2012 02/16/2012 AE 7 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)? ❑x Yes ❑ No Designation Date: 10/1/1983 x❑ CBRS ❑ OPA FILE COPY FEMA Form 086-0-33(7/15) Replaces a,,previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑x 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,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,enter meters. Benchmark Utilized: FDOT BM#10 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ❑x 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) 9.0 ❑x feet ❑ meters b) Top of the next higher floor 20 83 ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) 16 0 0 feet ❑meters d) Attached garage(top of slab) NSA. x❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 9 16 ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) NSA ❑x feet - ❑ meters g) Highest adjacent(finished)grade next to building(HAG) NSA. ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8.0 ❑x 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. Were latitude and longitude in Section A provided by a licensed land surveyor? 9 Yes ❑No ❑Check here if attachments. Certifier's Name License Number CHARLES ARNOLD, PSM LS 4971 Title VICE PRESIDENT Company NameI c ARNOLD SURVEYING, INC. S Address I re 4888 N KINGS HIGHWAY#425 City State ZIP Code FORT PIERCE Florida 34951 (> Signature Date Telephone -Z 17r (772)460-8211 - - Copy all pages of this Elevation ertificate and al attachments for(1)community official,(2)insurance agent/company, and(3)building owner. Comments(including type of equipment and location,per C2(e),if applicable) LATITUDE/LONGITUDE WAS OBTAINED USING A HAND HELD DEVICE;A/C PAD WAS USED AS LOWEST ELECTRICAL EQUIPMENT SERVICING BUILDING FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 s' OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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. EZ 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 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. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 ' OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 138-1310. 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 134-1310)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: E] 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(including type of equipment and location,per C2(e), if applicable) [� Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 7912 SOUTH OCEAN DRIVE 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 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 One Photo One Photo One Caption Photo Two Photo Two Photo Two Caption FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management,Agency Expiration Date: November 30,2018 National Flood Insurance Program AP 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. LOUIS SIMMERMACHER A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number: Box No. 7912 SOUTH OCEAN DRIVE City State ZIP Code JENSEN BEACH Florida 34957 A3, Property Description(Lot and Block Numbers,'Tax Parcel Number, Legal Description, etc.) LOT 4, DIAMOND SANDS PLAT NO.2 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.N27.320286 Long.W80.226529 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 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 3,603 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑Yes Z No A9. For a building with an attached garage: a) Square footage of attached garage 0 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes ❑x No SECTION B—FLOOD PNSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2. County Name B3. State UNINCORPORATED 120285 SAINT LUCIE Florida B4. Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12111 C 0303 J 02/16/2012 02/16/2012 AE 7 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ 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)? ❑x Yes ❑ No Designation Date: 10/1/1983 ❑x CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 0 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑x 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: FDOT BM#10 Vertical Datum:NAVD 1988 Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ❑x 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) 9.5 0 feet ❑ meters b) Top of the next higher floor N/A ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A X feet ❑meters d) Attached garage(top of slab) NSA. ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building NSA feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 5. 3 ❑x feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 6. 9 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 8.0 0 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. l 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. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑No ❑Check here if attachments. Certifier's Name License Number CHARLES ARNOLD, PSM LS 4971 Title VICE PRESIDENT Company NameI ARNOLD SURVEYING, INC. eal )- ;��Address e�T 4888 N KINGS HIGHWAY#425 1 City State ZIP Code FORT PIERCE Florida 34951 ^ Signature Date Telephone 11/02/2017 (772)460-8211 Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company,and(3)building owner. Comments(including type of equipment and location, per C2(e), if applicable) LATITUDE/LONGITUDE WAS OBTAINED USING A HAND HELD DEVICE FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 El—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 To of bottom floor(including basement, P ( 9 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 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. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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(including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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. i I - _ Photo One Photo One Caption FRONT VIEW-PHOTO TAKEN NOVEMBER 2,2017 I Via:: Photo Two Photo Two Caption REAR VIEW-PHOTO TAKEN NOVEMBER 2,2017 FEMA Form 086-0-33(7/15) 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 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 flood openings or vents, as indicated in Section A8. _.: I ,r � i i!d fi 1 FI lid; Photo One Photo One.Caption SIDE/SOUTH VIEW-PHOTO TAKEN NOVEMBER 2,2017 _ v Photo Two. Photo Two Caption SIDE/NORTH VIEW-PHOTO TAKEN NOVEMBER 2,2017 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 t U.S. DEPARTMENT OF HOMELAND SPURITY 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. 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: LOUIS SIMMERMACHER A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number: Box No. 7912 SOUTH OCEAN DRIVE City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 4,DIAMOND SANDS PLAT NO.2 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.N27.320286 Long.W80.226529 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 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 873 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑Yes [E No A9. For a building with an attached garage: a) Square footage of attached garage 1,022 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes ❑x No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number B2. County Name B3. State UNINCORPORATED 120285 SAINT LUCIE Florida B4. Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel B8 Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12111 C 0303 J 02/16/2012 02/16/2012 AE 7 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ 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)? ❑x Yes ❑ No Designation Date: 10/1/1983 ❑x CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑x 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: FDOT BM#10 Vertical Datum:NAVD 1988 Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ❑x 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) 9. 66 x❑ feet ❑ meters b) Top of the next higher floor WA 0 feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) 16 1 0 feet ❑meters d) Attached garage(top of slab) 8 1 0 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building NSA. 0 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 6 2 feet ❑ meters g) Highest adjacent(finished)grade next to building (HAG) 6. 5 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including NSA. X 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. Were latitude and longitude in Section A provided by,a licensed land surveyor? Z Yes ❑No ❑Check here if attachments. Certifier's Name License Number CHARLES ARNOLD, PSM LS 4971 Title VICE PRESIDENT Company Name `_ sac `1 ARNOLD SURVEYING, INC. 7) 'e _ Address N _ 4888 N KINGS HIGHWAY#425 �l City State ZIP Code 1 . FORT PIERCE Florida 34951 Signature Date Telephone 11/28/2017 (772)460-8211 Copy all pages of this Elevation Certificate all attachments for(1)community official, (2)insurance agent/company, and(3)building owner. Comments(including type of equipment and location,per C2(e),if applicable) ITEM A5 WAS OBTAINED USING A HANDHELD GPS UNIT; ITEM A9 REFERS TO GARAGE THAT IS SEPARATED FROM STORAGE, FOYER&EXERCISE RM BY EXTERIOR TYPE WALL MEANING GARAGE IS ATTACHED FOR THE PURPOSE OF THIS ELEVATION CERTIFICATE; ITEM C2A REFERS TO STORAGE, FOYER&EXERCISE RM ELEV; ITEM C2C REQUESTED BY LOCAL INSPECTOR:HOUSE IS NOT IN V ZONE; ITEM C213 REFERS TO GARAGE THAT IS SEPARATED FROM STORAGE, FOYER&EXERCISE RM BY EXTERIOR TYPE WALL MEANING GARAGE IS ATTACHED FOR THE PURPOSE OF THIS ELEVATION CERTIFICATE FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 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 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. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 I G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor(including basement) El feet ❑ meters Datum of the building: 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(including type of equipment and location,per C2(e), if applicable) ; ❑ Check here if attachments. FEMA Form 0867-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS .46 OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 7912 SOUTH OCEAN DRIVE 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 foundation with representative examples of the flood openings or i vents, as indicated in Section A8. If submitting more photographs than will fit on this page,use the Continuation Page. i II !I. l *rYz e. i ►-. � �- F�i1 �- '= —.'�—y �§$4 ,max 4 -- Photo One Photo One Caption FRONT VIEW-PHOTO TAKEN NOVEMBER 14, 2017 -T_: III... 1,l. {. I M s r -( .:.• J 'F�c�S��h"(Yf� < ISM rib�r+`. ��zr. ;,�„_,"1�.� , y : � w � r tt�� e ✓ a``c+�.� u F� r1..�Z s /e ( ,r 1 r's..`a. 'G°js (tTr c'` ✓,+e`3 3;ta'' e+a A P W;�"t `�L''',,,�v"�+. % e3Ca" .' Fr-e-�'`'a'"'v. g"�I r{l ��,' 4y+. 6�ft a�Tir� '��- ��, �. x i``' '�' c� �3�i(Jrt` X� it ,� ` •% �°i c• � 'fir"+i c Photo Two Photo Two Caption REAR VIEW-PHOTO TAKEN NOVEMBER 14,2017 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 i * 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: 7912 SOUTH OCEAN DRIVE City State ZIP Code Company NAIC Number JENSEN BEACH Florida 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 flood openings or vents,as indicated in Section A8. Photo One Photo One Caption Photo Two Photo Two Caption FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6