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Home My WebLink AboutElevation CertificateU.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY ELEVATION Y/y '\ CERTIFICATE r V 1 A'o.donal Flood insurance Program IMPORTANT: Follow the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION Al. Building owner's Name Aero Shade Technologies A2. Buildin Street Address (includin Apt., Unit Suite, and/or Bldg. No.) or P.O. Route and Box No. VO4-3106 Industrial Avenue Three City Ft. Pierce State FI A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Tax I.D. No. 1429-501-0105-000-4 OMB No. 1660-0008 Expiration Date: July 31, 2015 Job#:14-218 W A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) n- R si nt' I A5. Latitude/Longitude: Lat. 27 4949 N Long. _80.3570 W Horizont (n: ❑,NAD 1917- RNA 1983 A6. Attach at least 2 photographs of the building if the Certificate'.is,being used to obtain flood insurance. --�__ A7. Building Diagram Number 1a �``y A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/p sq ft a) Square footage of attached garage N/A s ft b) No. of permanent flood openings in the crawlspace or q enclosure(s) within 1.0 foot above adjacent grade 0 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 A8.b N/A sq in c) Total net area of flood openings in A9.b NIA s in d) Engineered flood openings? ❑ Yes ®No q • d) Engineered flood openings? El Yes ®No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. (V�FlPiComo unity Name & Community1 Number ,��^�^ B2. County Name I es4. map/Hanel Number 85. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base FloodiElevation(s) (Zone 12111 C0176 Revised Date AD, use base flood depth) J 02/16/2012 02/16/2012 X N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ®No Designation Date: / / ❑ CBRS ❑ OPA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ® Building Under Construction* *A new Elevation Certificate will be required when construction of the building is complete. ❑Finished Construction 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: St. Lucie Co. BM "Paul" Vertical Datum: 14.14' NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 Datum used for building elevations must be the same as that used for the BFE. ® NAVD 1988 ❑ Other/Source: a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 19 95 b) Top of the next higher floor N A c) Bottom of the lowest horizontal structural member (V Zones only) N , A d) Attached garage (top of slab) N A e) Lowest elevation of machinery or equipment servicing the building N A (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 19 , 0 g) Highest adjacent (finished) grade next to building (HAG) 19 2 h) Lowest adjacent grade at lowest elevation of deck or stairs, including N A structural support Check the measurement used. ® feet ❑ meters ® feet ❑ meters ® feet ❑ meters ® feet ❑ meters ® feet ❑ meters ® feet ❑ meters ® feet ❑ meters ® 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 certifv elevatinn Oluc 1U1 wnunuauon. Replaces all previous editions. r=, ELEVATION CERTIFICATE, page 2 IMPORTANT: in these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 3104-3106 Industrial Avenue Three compaPiyNAlcNUriber City State ZIP Code Ft. Pierce FI 34946 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. Certificate• performed only on form board. Avg. Elevation of Form Board = 19.95' Avg. Elevation of center line crown of road = 19.72' Elevation of #3104 (with 3/8"tile floof) = 19.76' Date SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (Will HUU I Orr-) 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. El. Provide elevation information for the following and cherk the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). feet meters [I above or ❑below the HAG. a) Top of bottom floor (including basement, crawlspace, or enclosure) is ® ❑ feet ❑meters Clbove or ❑below the LAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ® E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ®feet ❑meters ❑ above or E] 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 0 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 William E. Hayhurst Address 445 9th Street SW, Unit 7 city Vero Beach State FI ZIP Code 32962 � Signature Date Telephone (772) 569-6680 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 itemis) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. rchitect G1. G2. G3. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or a who is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. 171 The following information (Items G4—G9) 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: El feet [I meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: C] feet El meters Datum El feet El meters Datum G10.Community's design flood elevation: Local Official's Name ; Title e Community Name Telephone Date Signature Comments ❑ Check here if attachments. Replaces all previous editions. FEMA Form 086-0-33 (7/12)