HomeMy WebLinkAboutElevation CertificateD
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;� v v EMERGENCY MANAGEMENT All �Y "�
% O.M.B. No. 3067-0077
I FeA;1Y , Cj (/�4�h TIONAL FLOOD INSURANCE PROW, "'OK Expires December 31, 2005
MAR o s coos E EVATION CERTIFICATE
BY: nVn Im rtant:. Read the instructions on pages I.7..
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
HAROLD HYMES
-BUILDING STREETADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
5347 MONTEGO CIRCLE
CITY.. STATE ZIP CODE
FT. PIERCE FL 34949
LOT 359, OCEAN RESORTS COOPERATIVE
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary,)
RESIDENTIAL
LATITUDE/LONGITUDE.(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
or ##./°) ® NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
NAME 2 285 ST. LUUCIE COUNTY MUNITY NUMBER I BL• STATE
UNINCORPORATED
B4. MAP AND PANEL
I
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUMBER
B5. SUFFIX
86. FI
M INDEX DATE
EFFECTIVEIREVISED DATE
B8. FLOOD ZONE(S)
(Zone AO, use depth of flooding).
12111CO087
G
�6/30/99
11/411992
AE
5.00
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depthentered in B9.
❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other (Describe):
B11, Indicate the elevation datum used for the BFE in 139: 0 NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a,Coastal Barrier Resources�System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on, ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 5 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram
accurately represents the building, provide a sketch oil photograph,)
C3. Elevations —Zones Al A30, AE, AH, A (with BFE), V , V1430, V (with BFE), AR, ARIA,AR/AE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3: as below according to the building diagram specified in Item C2• State the datum used. If the datum is different from the datum used for the BFE in
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum NGVD 1929 Conversion/Comments
Elevation reference mark used NAIL Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No
o a) Top ofboftom-floor (including basement or enclosure) 8. 03 ft•(m)
o b) Top of next higher floor N/A. _ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only) ..,N/A. _ft.(m)
o d) Attached garage (top of slab) N/A, _ft,(m)
o e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a •Comments area) 6.05 ft.(m)
o f) Lowest adjacent (finished) grade (LAG) 4.00 ft.(m)
b g) Highest adjacent (finished) grade (HAG) N/A.
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A
o i) Total area of all permanent openings (flood vents), in C3•h N/A sq. in. (sq. cm)
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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 in Sections A, B, and C 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.
CERTIFIERS NAME DANIEL W. TALBOTT V I LICFNSF Nt1MRFR 5M2
SURVEYOR AND MAPPER
1179 OLD DIXIE HWY•
SIGNATUR
NAME TALBOTT.V P.S.M. INC.
VERO BEACH
UAIE
1/11/06
STATE ZIP CODE
FL 32960 .
TELEPHONE
FEMA Form 81-31, January 2003 See reverse side for continuation: Replaces all previous editions-
ANT: In these spaces. coov the
from Section A.
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, andlor W. OR P.O. ROUTE AND BOX NO. !
5347 MONTEGO CIRCLE
CITY ) STATE' ZIP CODE
FT. PIERCE FL 34949
SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTI
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner,
COMMENTS
j Far Insurance Company •Use: .
Policy Number 7
Check here if attachments''
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
El. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is t.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ f ..(m) _in.(cm) above the highest adjacent
grade. Complete items C3,h and C3J on front of form.
E4, The top of the platform of machinery and/or equipment servicing the building is — ft.(m) _in.(cm) ❑ above or.. ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available),
E5. Far Zone A0 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; C (Items C3.h and'C3.i only), and,E for Zone A (without a FEMA4ssued or community -
issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to'the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME -
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
Check here if attachments
The local offcal 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.
G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local 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-G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER I G5. DATE PERMIT ISSUED I G6, DATE CERTIFICATE OF
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8, Elevation of as -built lowest floor (including basement) of the building is: _ft.(m) Datum:
G9, BFE or (in Zone AO) depth of flooding at the building site is: _ fl,(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions
P T # 9� -Ai ccTRALEMERGENCYMANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
a 5�p�oELEVATI0N CERTIFICATE
Important. Read the instructions on pages 1.7.
SECTION A - PROPERTY OWNER INFORMATION
BUILDING OWNER'S NAME
HAROLD HYMES
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
5347 MONTEGO CIRCLE i
O.M.B. No. 3067-0077
Expires December.31, 2005
For Insurance Company Use:
, I Company NAIC Number
CITY STATE ZIP CODE
FT. PIERCE FL 34949'
PROPERTY DESCRIPTION (Lot and Block Numbers; Tax Parcel Number, Legal Description, etc.)
LOT 359, OCEAN RESORTS COOPERATIVE
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) ' HORIZONTAL DATUM: SOURCE: LJ GPS (Type):
##.##" or ##.�°) ® NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUMBER i 182, COUNTY
COUNTY FL STATE
UNINCORPORATED 120285LUCIE
84. MAP AND PANEL
87. FIRM PANEL
B9. BASE FLOOD ELEYATION(S)
NUMBER
B5. SUFFIX
B6. FIRM, INDEX DATE
EFFECTIVEIREVISED DATE
B8. FLOOD ZONE(S)
(Zone AO, use depth of flooding)
12111CO087
G
6/30/99
1114/1992
AE
5.00
B10, Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe):
B11, Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawilrgs* ® Building Under Construction" ❑ Finished Construction
"A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number I (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram
accurately represents the building, provide a sketch or photograph.)
C3. Elevations — Zones Al-A30, AE, AH, A (with BFE), VE, V11430, V (with BFE), AR, ARIA, ARIAE, AR/A1-A30, ARIAH, ARIAO
Complete Items C3.-a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the dat tin
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or dVV��n r f
Section D or Section G, as appropriate, to document the datum conversion,
Datum NGVD 1929 Conversion/Comments
Elevation reference mark used NAIL Does the elevation ieference mark used appear on the FIRM? ❑ Yes ® No
o a) Top of bottom floor (including basement or enclosure) 8, 03 ft.(m) Q)
o b) Top of next higher floor NIA.. _ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only) N/A . 00
o d) Attached garage (top of slab) N/A. _ft.(m) 1
o e) Lowest elevation of machinery and/or equipment f w `°
kT 9
servicing the building (Describe in a Comments area) NIA'
o 0 Lowest adjacent finishedgrade (LAG
o g) Highest adjacent (finished) grade (HAG) N/ .M005
o h) No. of permanent openings (flood vents) within 1 ft.,above adjacent grade N/A
o i).Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm)
SECTION D;- SURVEYOR,
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 in Sections A, B, and C 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.
CERTIFIERS NAME DANIEL W. TALBOTT V LICENSE NUMBER 5642
TITLEPROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME TALBOTTV P,S.M, INC.
ADDRESS CITY STATE ZIP CODE
1360 S.W. OLD DIXIE HWY. SUITE 101 VERO BEACH FL 32967
SIGNATURE �� DATE TELEPHONE
8/17/05 (772) 569-8884
FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corre, " ;ling information from Section A. For Insurance Company Use:
.;, BUILSING STREET ADDRESS (Including Apt., Unit, Suite, ante <'. No.) OR P.O. ROUTE AND BOX NO. Policy Number
5347 MONTEGO CIRCLE
CITY STATE ZIP CODE Company NAIC Number
FT. 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
Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
El. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed —see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The tap of the bottom floor (including basement or enclosure) of the building is _ ft,(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ft.(m) _in.(cm) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. `(Use
natural grade, if available).
E5. For 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?
ElYes ElNo ElUnknown. 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, C (Items C3.h and C3.i only), 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, G, and E are correct to the best of my knowledge.
PROPERTY OWNER'S 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,
G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information. (Indicate th'e source and date of the elevation data in the Comments area below)
G2. ❑ A community official completed Section E for a buildingl located in Zone A (without a FEMA-issued or community -issued BFE) or Zone A0,
G3. ❑ The following information (Items G4-G9) is provided foricommunity floodplain management purposes.
G4. PERMIT NUMBER I 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 is: _ft.(m) Datum:
G9, BFE or (in Zone AO) depth of flooding at the building site is; ft.(m) Datum:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
TITLE
TELEPHONE
SIGNATURE DATE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions