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HomeMy WebLinkAboutElevation Certificate ( Disapproved )U,S. EYEPARv MENT OF HOMELAND SECURITY L L L V A 11 U N U L K I I r UA I t 1 sj�0 D' FEDERAL. EMERGENCY MANAGEMENTAGENCY OMB NO. 1660-0008 National,01oodln§uri:ncePrdgram K Impor Read the instructions on pages 1-9 Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Randy D Rinicella & Lisa C Rinicella I roucy ivumoer. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number. I 100 Island Dune Cove (Addition Only) City Jensen Beach*" State FL ZIP Code 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 2, LAS TORTUGAS at HUTCHINSON ISLAND, ST. LUCIE COUNTY A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27.306526Long. 80.221749Horizontal 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. A9. For a building with an attached garage: ((approximate) N/A sq ft a) Square footage of attached garage 542 sq ft -iwispace b) Number of permanent flood openings in the attached garage grade NIA within 1.0 foot above adjacent grade 3* NIA sq in c) Total net area of flood openings in A9.b 372* sq in - ]No (Unknow) d) Engineered flood openings? ❑ Yes❑ No Unknown FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B2. County Name B3. State ST LUCIE COUNTY i_. FLORIDA t A Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Effective/Revised Date Zones) AO, use base flood depth) 1612012 02/16/2012 AE 6,7 1� FE) data or base flood depth entered in Item B9. Cunity Determined ❑ Other/Source: I❑ NGVD 1929 X NAVD 1988 ❑ Other/Source: s System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes X No ❑ CBRS ❑ OPA ILDING ELEVATION INFORMATION (SURVEY REQUIRED) ® Iuction Drawings' ❑ Building Under Construction* X Finished Construction 7 I nstruction of the building is complete. V7 V30, V (with BFE), AR, ARIA, AR/AE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the eunaing ao6�i Item AT In Puerto Rico only, enter meters. Benchmark Utilized: FLDT 94 77 A 06 - El. 3.58* Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑ NAVD 1988 X 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) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 7_2 X feet ❑ meters NIA ❑ feet ❑ meters N/A. ❑ feet ❑ meters 6_7 X feet ❑ meters 7.1* ❑ feet ❑ meters 6_4 X feet ❑ meters 6_9 X feet ❑ meters N./A 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. I certify that the information on this Certificate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. x Check here if comments are provided on back of form. Were latitude and longitude in Section A provided.by a JO 1.311-03 ❑ Check here if attachments. ; . licensed land surveyor? x Yes ❑ Noin Certifier's Name REGINA KARNER License Number 4363 Title President" 1 _ Company Name KARNER SURVEYING INC FL R I-drB 31 16!- ReviseR$.10 16" Signature FEMA Form 08 -0 3 (7/12) Date 3/23/2016 Telephone (772) 288 7206 See reverse side for continuation. ELEVATION 2 IMPORTANT; In these spaces, copy the co Building Street Address (including Apt., Unit, Suite, 100 Island Dune Cove (Addition Only) •ionding information from Section A. FOR INSURANCE COMPANY USE r Bldg. No.) or P.O. Route and Box No. TPolicy Number. City Jensen Beach State FL ZIP Code 34957 I Company NAIC Number. I SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Eleva)(On Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Residence is it most part in Zone AE with Base Flood Elevation 7.Only a sliver of the Breezeway in the back falls within 6. U Base Flqpd Elevation tility Servicing the Building: *concrete pad with raised Aluminum Frame for A/C Units as noted hereon Date 3/23/2016 Revised 4.19.2016* SEC'HdN 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. El. 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 CE,RTI1FIQ4TE, page 3 30ding Photographs See Instructions for Item A6. 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 100 Island Dune Cove (Addition Only) 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 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELFWATION CEI$TIFICA?TE, Page 4 30ding 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.) or P.O. Route and Box No. Policy Number. . 100 Island Dune Cove (Addition Only) 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 Viee 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. LEFT FEMA Form 086-0-33 (7112) Replaces all previous editions.