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HomeMy WebLinkAboutElevation Certificate 10-22-13'RECEIVE&OCT 22 2013 , U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE'`"`' :OMB No. 1660-0008 FEDERAL EMERGENCY -MANAGEMENT AGENCY ,National Flood Insurance Program .'IMPORTANT: Follow•the instructions on.pages 1-9.+ Expiration,Date: July 31; 2015 " SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name PATEL RESIDENCE / PHOENIX.REALTY HOMES INC. Policy Number: A2.' BuildingStreet Address (includin A t:; Unit Suite 'and/.or.'Bldg. No.) or P.O. Route,and Box'No:., Company NAIC Number: 400 A1A, N HUTCHIISON ISLANb •' City FORT PIERCE _. - ' •I I. _ -State FL ZIP Code 34949 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL ID 1414-310-0006-000-8 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL' A5. Latitude/Longitude: Lat. 27 31 fl3 74 N Long. 80 18 32.92 W 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 R A8. For a building with a crawispace or:enclosure(s): A9. For a building with an attached garage: . a) Square footage of crawispace or enclosure(s) N/A ` sq_ft a) Square footage of attached garage 1,239 sq ft b) Number of permanent flood. openings in the crawispace NSA - b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above"adjacent grade within 1.0 foot above adjacent grade NIA 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 • N No SECTION S -'FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community -Name & Community Number B2. County Name_ B3. State UNINCORPORATED •-120285 ST. LUCIE FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel'Effective/ B8. Flood Zone(s) B9. Base Rood'Elevation(s) (Zone Revised Date AO, use base flood depth) 12111 C 0093 . 1 02/16/2012 02/16/2012 AO & VE AO (-1'), AO (-2'), VE (14') 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: 811.Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: 612.Is the building located in a Coastal Barrier Resources System (CBRS);area• pr Otherwise Protected Area •(OPA)? ❑ Yes ❑ No Designation Date: _ / ` % ❑ CBRS ❑ OPA SECTION "C - BUILDING .ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* .N Building Under Construction* ❑ 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, 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 NGS N-633 JVertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑ NAVD-1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawispace, 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) 0 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 of stairs, including structural support Check the measurement used. 13 , 23 ". N feet ❑ meters N/A I-] feet . ❑meters 20 , 74 ® feet ' ❑ meters 13 ; 48 N feet ❑ meters N/A ' ❑ feet ❑ meters 71 N/A . ❑ feet ❑ meters N/A : ❑ feet ❑ meters N/A , ❑ feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION . This certification Is to be signed and•seaied by a land surveyor, engineer, or architect authorized by law to certify elevation information: 7 certify that the information on this Certificate represents my best efforts to Interpret the data available. 1 understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. [D Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a IT Check here if attachments. licensed land surveyor? . ® Yes" . ❑ No MA Form 086 0 33 (Revised 7/12) See reverse. side. for continuation. -- -Replaces all previous editions. 41 � ELEVATION CERTIFICATE -,page 2 :. 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: 4600 AM N HUTCHINSON ISLAND City State ZIP Code. -company NAIC Number: .FORT PIERCE FL 34949 SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINVED) Copy both sides of this, Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments LATITUDE / LONGITUDE WAS OBTAINED USING A HANDHELD GPS UNIT 42 Signature Date 10/22/2013 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 E1-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 0 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 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. Perm Permit Issued - '1 ,' I' G6. Date 37. This permit has been issued for: " ❑ New Construction ❑ Substantial Improvement �8. Elevation of as -built lowest floor (including basement) of the build_ ing: - • I O,feet' ❑meters Datum - 39. BFE or'(in Zone AO) depth of flooding at :the building site:. El 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 (Revised 7/12) Replaces all previous editions.