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HomeMy WebLinkAboutElevation CertificateU.S.,DEPARTMENT.OFHOMELAND SECURITY LEVATION CERTIFICATE''. FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 Nttional Flood Insurance Program EX iration Date: Jul 31, 2015 Important: Read the instructions on pages 1-9. p Y SECTION A" PROPERTY INFORMATION :: FOR INSURANCE COMPANY USE -,Al;. Building Owner's Name • FPL C&T Job No. 14-099 PolipyA umber A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC,Number.­ 6501 South Ocean Drive, Building 14 City Jensen Beach State FL . ZIP Code 34957 A3. Property Description (Lot and Block Numbers,:Tax Parcel Number, Legal Description; etc.) SLC Tax ID 3508-111-0002-000-3 ' A4. Building Use (e.g., Residential, Non -Residential, Addition; Accessory, etc.) Non Residential - A5: Latitude/Longitude: Lat. 27.3476°N Long. 80.2433`W Horizontal Datum: ❑. NAD 1927: ® 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): A9. For a building with an attachedgarage: a) Square;footage of crawispace or enclosure(s) : ; N/A. sq ft :: a), Square, footage of attached garage N/A • sq ft b) Number of permanent flood openings in the crawlspace b) . Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) .Total net area of flood openings in A8.b ' N/A sq in c) Total net area of flood openings in A9.b:.N/A sq in d) Engineered flood openings? ❑ Yes ® No d) :Engineered flood openings? ❑ . Yes - ' ® No SECTION B= FLOOD:INSURANCERATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name:. B3. State_ St. Lucie County, 120285 St. Lucie County, FL' 84. Map/Panel Number:: . B5. Suffix B6. FIRM Index Date B7. FIRM Panel 68. Flood :. B9. Base Flood Elevation(s) (Zone.. 12111C0301 .. J. 2-16-2012 Effective/Revised Date: .. Zone(s) ..AO, use:base flood depth); 2A 6-2012 AE. 6 B10. Indicate the source of the Base Flood- Elevation (BFE) dataor, base flood depth entered in Item 139: -. . ❑ : FIS Profile , . ® FIRM: ElCommunity Determined ❑: Other/Source: B11. Indicate elevation; datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 :. El Other/Source: 612. Is the building located in a:Coastal BarrierResources.System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No :. Designation Date: N/A ❑' CBRS _ ❑ OPA SECTION C -:BUILDING-ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on:: ❑ Construction Drawings* ❑ , Building Under Construction- ® Finished Construction` *Anew Elevation Certificatewill 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/ .Al-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram'specified in Item A7. In Puerto Rico only, entermeters. Benchmark Utilized: NGS No: "C-308" Vertical Datum: `NAVD 1988 •: Indicate. elevation datum used for the elevations in items a) through h) below. Q NGVD 1929 ® 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) 13.82 . ® feet: ❑ meters b), Top•of the next higher floor N/A'. ❑feet El 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) Cowest elevation of machinery or equipmentservicing-the building 13.50 ®-feet ❑ meters' (Describe type of equipment and location in Comments) f)' Lowest adjacent (finished) grade nextto building.(LAG) : 12.6 ®'feet ❑ meters . . g) Highest adjacent (finished) grade next to building (HAG), : 13.8 ®_ feet ❑ meters h). Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A. ❑ 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. 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. ❑ Check here if comments are provided on back of form. Were latitude and:longitude in Section A provided by a ❑ Check here if attachments. .licensed land surveyor? ® Yes ❑ No Certifier's Name Thomas P. Kiernan License Number 6199' Title Professional, Survey Company Name Culpepper & Terpening, Inc. Address 2980 S. 25`" Street City Fort Pierce a State FL ZIP Code 34981 Signature Date 7-31-20.14 Telephone (772) 464-3537: FEMA Form 086-0-33 (7112) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCECOMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 6501 South Ocean Drive, Building 11 City Jensen Beach State FL ZIP Code 34957 Company NAIC Number: 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 C2. e, AC pad is lowest machinery servicing the building. Signature Date 7-31-2014 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 8-9 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'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. 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 Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION: CERTIFICATE, page 3 ; 4' Building Photographs �1 See' Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE'COMPANY'U.SE Building Street Address (including Apt., Unit, Suite,_and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 6501' South Ocean Drive; Building 11 City Jensen Beach State FL . ZIP Code 34957 Company NAIC Number:' If using the; Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs belowaccording to the instructions :: for -item A6. Identify all photographs with date taken; "Front Viev1` 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.. FEMA Form 086-0-33 (7/12) Replaces all previous editions. EL,EV'ATIO.N CERTIFICATE, page 4 Building Photographs Continuation Page 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.) br P.O. Route and Box No. Policy Number: 650.1. South Ocean Drive; Building 11 City Jensen Beach. State. FL ZIP Code 34957 Company NAIC Number: 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions.