HomeMy WebLinkAboutElevation Certificate 2-23-17( U.S. DEPARTMENT OF HOMELAND S MB No.1660-0008
Fed ~
Federal Emergency Management Agency , I 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:
VERION & BARBARA BENNETT
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
10751 SOUTH OCEAN DRIVE #Al0
City State ZIP Code
JENSEN BEACH Florida 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT A-10 VENTURE HARBOR PID #4511-311-0014-000-7
A4. Building Use (e.g.-, Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°16'07.8" Long.-80°30'28.5" 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 8
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 1577 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 8
c) Total net area of flood openings in A8.b 1600 sq in
d) Engineered flood openings? x❑ Yes ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garage 480 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 3
c) Total net area of flood openings in A9.b 600 sq in
d) Engineered flood openings? x❑ Yes ❑ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORP 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 C 0314
J
02/16/2012
02/16/2012
AE
7.0
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
❑ 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. r r Form Pagel of 6
k No. 1660-0008
-ELEVATION CERTIFICATL� 1 icMB piration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresp�.Ang 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:
1,c) a i v or —
City State ZIP Code
'A E" S,E#J RWAACO-f FLr 0 3 Li I S -7
Company NAIC Number
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 A02 RM1 FDOT Vertical Datum: NAVD 1988
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) 4. 9 0 feet ❑ meters
b) Top of the next higher floor 8. 3 0 feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters
d) Attached garage (top of slab) 4. 1 x❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 9. 6 ❑x feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 4. 0 x❑ feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 3. 8 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4. 0 ❑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 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.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑x Check here if attachments.
Certifier's Name License Number
1 �Z� .• ®l v4.
EARLE R. STARKEY 004459
Title
PROFESSIONAL LAND SURVEYOR - -- -
- -- -
Place
Company Name
ACCURIGHT LAND SURVEYING INC.
Seal
Here
Address
1501 DECKER AVENUE #419
�Z �3 l 1 "7
City State ZIP Code
ST Florida 34994
I?LS JP y q S
ature Date Telephone
772-286-7694
opy all pa his E ertificate 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)
A8-D & A9-D SMART VENT MODEL #1540-520 C2-E A/C PLATFORM
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
iilding Photographs
See Instructions for Item A6.
01 For insurance Company Use:
cvl" Street Address (irxtucling Apt,, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Poky Number
10751 SOUTH OCEAN DRIVE #A10
city state ZIP Code C ripwW WM n wim
JENSEN BEACH FLORIDA 34957
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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 vim and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
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