HomeMy WebLinkAboutElevation CertificateU.S. DEPARTMENT OF HOMELAND'' .:6URITY t y 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:
Andrew J. Stefanik and Lynn M. Stefanik
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
1844 Wildcat Cove Drive
City State ZIP Code
Ft. Pierce Florida
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 44, Riverpoint at the Sands Phase II
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) . Residential
A5. Latitude/Longitude: Lat. 27° 29' 32.31" Long. 80° 18' 21.66" 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 1A
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0 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 0 No
A9. For a building with an attached garage:
a) Square footage of attached garage 533 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 120285
St. 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 C0181
J
02/16/2012
02/16/2012
AE
5
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 69: ❑ 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 (7/15) Replaces all previous editions. Form Page 1 of 6
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:
1844 Wildcat Cove Drive
City State ZIP Code
Company NAIC Number
Ft. Pierce Florida
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, VI—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: 94 77 A 29 Vertical Datum: NAVD 88
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) 5.49 X❑ feet ❑ meters
b) Top of the next higher floor NSA. ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) NSA. ❑x feet ❑ meters
d) Attached garage (top of slab) 5 10 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 5 13 x❑ feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 4.25 0 feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 5.16 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 Cerfificate 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
Michael T. Owen LS5556
"
".
Title
Vice President
' '
� :��t ±' ;y, S�ai r�•
Company Name
Engineering, Design & Construction, Inc.
Address
10250 SW Village Parkway, Suite 201
4
City State ZIP Code
Port St. Lucie Florida 34987-2362
Signatur Date Telephone
02 I3/2017 (772) 462-2455
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)
Equipment in Section C.2.e) is air conditioner condenser servicing house.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
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:
1844 Wildcat Cove Drive
City State ZIP Code
Company NAIC Number
Ft. Pierce Florida
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) Top of bottom floor (including basement,
N/A.
crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is N/A . ❑ 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 N/A . ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is N/A . ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is N/A . ❑ 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
N/A
Address City State ZIP Code
N/A N/A N/A
Signature Date Telephone
Comments
N/A
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
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:
1844 Wildcat Cove Drive
City State ZIP Code
Company NAIC Number
Ft. Pierce Florida
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
N/A
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement)
El ❑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
N/A N/A
Community Name Telephone
N/A
Signature Date
Comments (including type of equipment and location, per C2(e), if applicable)
N/A
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. I 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:
1844 Wildcat Cove Drive
City State ZIP Code
Company NAIC Number
Ft. Pierce Florida
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.
'� FoM,
Rt'n' 'srs'y` "!
kY
Photo One
Photo One Caption Front View - Taken 2.11.17
s
n�P..=jam
3.;574
Photo Two
Photo Two Caption Northeast corner - Taken 2.10.17
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: November30, 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:
1844 Wildcat Cove Drive
City State ZIP Code
Company NAIC Number
Ft. Pierce Florida
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 Northwest comer- Taken 2.10.1.7
Photo Two
Photo Two Caption West side - Taken 2.10.17
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6
Date: l 16/17
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772-462-6443
Request for 30-Day Temporary Power Release
Permit Number: 16o 3 - p 3-7 y
Project Address: 1944 --l-Dr,
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requested for the above stated purpose only, and there will be no
occupancy of any type, other than that permitted by construction during this time period.
2. As witness by our signatures, we hereby agree to abide by all terms and conditions of this agreement,
including Building Division Policy, which is incorporated herein by reference.
3. All conditions and requirements listed in the attached document entitled "Requirements for 30 Day
Power for Testing" have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed from the site and/or -a Stop Work Order issued if
the Final Inspection has not been approved within 30 days. A fee of $100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE _
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER , , � r ►, .
i
i
G RA CT R SIGNATURE DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE
RECEIVED
JAN 0 6 2017
St. Lucie County
Building and Zoning Department
Requirements for 30 Day Power for Testing
I. Form entitled "Request for 30-Day Temporary Power Release" must be fully executed and posted in
the Building Department record files prior to inspection.
II. Inspection Requirements:
1. Address numbers shall be posted per county Ord. No. 7.05.09.
2. All entrances, exits, windows and garage doors must be lockable.
3. All circuits on exterior shall be terminated in a box with weatherproof cover. The same applies
to a disconnect. If circuits are at or above 7'6" from grade they may be capped with wire nuts
and taped.
4. All breakers must be installed. Any blank space must be closed by a breaker or approved filler
plates.
5. Interior Wiring: All receptacles, light fixtures and fans must be trimmed. Any fixture below
7' 6" from the floor or mezzanine that is not available at the time of inspection must have an
Inviso plate installed. Fixtures at or above that height may be capped with wire nuts and taped.
6. All smoke detectors must be installed.
7. Kitchen cabinets must be installed; any exception for special conditions or circumstances must
have an approval prior to scheduled inspection.
8. Sewer and water connections must be complete. Only well pumps are excluded from this
requirement.
9. Exterior construction must be complete and weather tight, including stucco, siding, roof and
soffit.
10. Permit work shall be substantially completed except for back orders, paint on exterior, carpet
and/or floor covering, pumps, air conditioners and driveway.