HomeMy WebLinkAboutFlood Elevation Certificate Y
U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30,2022
National Flood Insurance Program - . '
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1)community.official, (2)insurance agent/company, and(3)building.owner:
SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY-USE
Al. Building„Owner's Name Policy Number: '
LAWRENCE&MAUREEN SOKOLOWSKI #4058-97 =
A2.. Building-Street Address(including Apt., Unit, Suite, and/or Bldg. No:)or P.O..Route and Box No. Company NAIC Number:
325 NETTLES BLVD
City State ZIP Code
JENSEN.BEACH Florida 34957 -~
A3. Property,Description.(Lot and Block Numbers, Tax Parcel Number,..Legal Description,etc.)
LOT 325, NETTLES ISLAND (#4502-501-0511-000-6)
A4. Building Use(e:g:,.Residential, Non-Residential,Addition,Accessory;etc.) RESIDENTIAL
A5.. Latitude/Longitude: •Lat.27°17'11.5116"N Long.,-80°13'29.0202'>W -.,Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 '•
A6. Attach at least)2photographs 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):
a) ,Square footage of crawlspace or enclosure(s) 877`00 sq ft
b) Number of.;permanent flood openings in the crawlspace or enclosures)within 1.0 foot above adjacent grade 12
c) Total net area of flood openings in A8.b 968.40 sq in
d) Engineered flood openings? ❑x Yes ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garage 0.00 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 0.00 sq in
d),`Engineerecl flood,openings? ❑Yes RI No
-! r_SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
NFIPLCommunity Name&Community Number B2. County Name B3. State
�iu.'LUC!E-CTY UNINC-ARE6S 120285 ST. LUCIE Florida
✓ _ ^: r
B4. Kap/Panel _B5,.Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
=N'ymber _% Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
12111C031.1'- '� K• ' 02-19-2020 02-19-2020 X N/A
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 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)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 1 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt_Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No... Policy Number:
325 NETTLES BLVD.
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•berequired 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: F-308 ELEV. &86': Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below.
❑ NGVD 1929 ❑x NAVD1988 ❑_Other/Source:
Datum used for building elevations must be.the same as that used for the BFE.
C_h eck the measurement used.
a) Top of bottom floor(including basement;crawlspace, or enclosure floor) 5.71 ❑x feet ❑ meters
b) Top of the next higher floor 8:52 `, ❑x feet ❑ meters
'. c) Bottom of the lowest horizontal structural`member(V Zones only) N/A ❑ feet ❑meters
d) Attached garage(top of slab) ;_.._ N/A: _❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building "8,89 ' 0 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade nett-to building(LAG) .4.59 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 560 ❑x feet - ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support 5.71 ❑x 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.
/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 attachme ts.
Certifier's Name License Number
STEPHEN J. BROWN, PSM L.S.4049
Title
PROFESSIONAL SURVEYOR D MAPPER
Company Name
STEPHEN J. BRO �/
Address
619 EAST H STREE "
City State ZIP Code
STU T Florida 34994
Sig ature Date Telephone Ext.
03-04-2021 (772)288-7176
Copy of this Elevaton 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)
A8 FLOOD SOLUTIONS FLOOD VENT MODEL#FS-1608
ENCLOSED AREA COVERAGE 97 sq.ft. PER VENT, NET FREE AREA OPENING 80.7 sq. in. PER VENT
TOTAL COVERAGE OF 12 VENTS AT 97 sq.ft. PER VENT EQUALS 1164 sq.ft.
A8 c TOTAL COVERAGE OF 12 VENTS AT 80.7 sq. in. PER VENT EQUALS 968.4 sq. in.
C2 e IS THE BOTTOM OF THE A/C UNIT
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 2 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30,2022
IMPORTANT: In these=spaces,copy the corresponding information from'Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
325 NETTLES.BLVD.
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 E1—E4, use natural grade, if availalile:,Xheck 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'+74, t
the highestadjacent grade(HAG)and the lowest adjacent grade(LAG): :,;�
a)'Top of bottonY f loop(including basement, -
crawlspace, or.ericlosure)is;1.. _,,❑,.feet ❑meters ❑above or ❑below the HAG.
b) Top of ti6ftri floor(including basement,
crawlspac6;.or enclosure)is ❑,feet E]meters E]above or ❑below the L'AG.
E2. For Building,Dia,arams,6-9 with permanent flood openings provided in':Section A`.Ite'ms 8 and/or 9(see pages 1-2 of Instructions),!' `.`
the next higherlfloor(elevation C2.b in
the diagrams�.)°'ofthe building is -_❑'feet ❑meters ❑above or ❑below the HAG'
E3: Attached garage(.top of slab)is ; ❑feet El meters ❑above or ❑below the HAG. ,
E4: Top of platform�of machinery and/or equipment -- H - = r • -�
servicing the b_U lding:is w❑feet ❑meters ❑above or ❑below the HAG:. .
E5. Zone AO onlys.if n`o';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(12/19) Replaces all previous editions. Form Page 3 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022
IMPORTANT: In these spaces,copy the-,corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
325 NETTLES BLVD.
City s : State ZIP Code Company NAIC Number
JENSEN BEACH Florida 34957
4 SECTION G—COMMUNITY INFORMATION(OPTIONAL)`: t
The local official who is authorized by-law or ordinance to administer the community's floodplair f anagement ordinance can complete
Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check themeasurement
used in Items G8—G10. In Puerto Rico only,enter meters. _•..v
G1. ❑ The information in Section. ;vtias'takeh 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:) r
+G2 ❑ A community official completed.;Section.�for a;tuilding located in Zone A(without a FEMA=issued'or community-issued BFE)
or Zone AO.
G3. ❑ The following information(Items G4=910)is provided for community floodplain management,purposes.
G4. Permit Number ``:_. G5. Date Permit Issued G6c .Date Certificate of
Compliance/Occupancy Issued
G7. This permit has been issued for: "4 ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor(iriclading 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(12/19) 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 30,2022
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O.Route and Box No. Policy Number:
325 NETTLES BLVD.
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.
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Photo One
Photo One Caption FRONT/SIDE VIEW 03/02/2021 Clear Photo One
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Photo Two
Photo Two Caption SIDE/FRONT VIEW 03/02/2021 Clear Photo Two
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November30,2022
IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
325 NETTLES BLVD.
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,
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777-777,
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Photo Three
Photo Three Caption REAR/SIDE VIEW 03/02/2021 I Clear Photo Three'
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Photo Four
Photo Four Caption SIDE/REAR VIEW 03/02/2021 Clear Photo Four
FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 6 of 6