HomeMy WebLinkAboutElevation Certificate 4-01-09A4. Building Use (eg.,Addition ,Accessory, etc.) Residein
, A5,Lat de tu qgitudi.--, ff N Long. w Horizontal, MUM: 'O.NAD 1927 M NAD 1983
A6- Aftc h h- thi b Ming
h:aH000t,Z,Oh*O pwo 0" w iqa a. s Wing used to ob.tolljolod I
MP
A'7..
A8. For a building w&11,4 crawl-soace. or enclo- ur#prov
ide , A9.::f.br a.building with-ptovidw.
A) Squats -t-fd . '-0taget of Of"i'va6a ove:nclbsum1843
(sy�. sq It 6 6ani n1a sq it
of perivan6�t 0 n theaftached garage.b), No: fiihp in : the d6wi.`
i$*sqre'(0),w4lW,Wft'. 16 1.61�dt above AdI41 60tA44encl Fade _Q Wells Within 11. J:adjacentvade: Max
0: Tot A'at area oflod gpeningsin>ABb sq in Total Oj`
hlqiln:ABL. sq in
iNFORl'_M.QTi
BI G 1 0 . . . m - U
F --F—NFlP C
.State
UNINCORPORMEDAREAS, 20285
NE
-54, W15Pirlbl Ndmgiitr
12`11-1160194
".1135.SWIX
G
Dafe
87.. FIRKP��h'&
Effective/Revised
I
138-� Flood
zones}
v
139.,Base FlOodElevaP411((Zone
base flood depth
810; Indicate the source :bf.the B I hWF16od.ElevatioK,( "idift Item BI
0 PIS Profile F (R. M..., 0. -Odmmunityp4qOrminod
1311. lhdicat6,elevaftondatum otec-.fdeB;.Ein:item i6k,*o:4GVD-1929 JNA,W4980t O:Oifier-(OqOcnbe)
B12. Isthabuitdih located in a. arad`Of.Q16ONProtected Araa.(OPA ?
Myes ONO
w Designation Date 19-83 tgks
C1. Btjildihg:ptevagohg,ziro�'based:ori:
-,qqf,-,rq. ngs
*A n6W. Elevation Certificate wil[be ofthe bc
C2. ,Elevations-:ZohevAIAW AE AH, A V(with
befoW adcdrdl4§ tbAh&.bOjldlpg'.Idi Ogiriam si-peciffiadjwl*.... -V�
Benchmark*Utilized LOCAL Vertical.Datum NGV6.4-ii
ConVersion/Comments;
a) Tdp�ofbottorh:flour (iriOu.t(i4g�b;iOth6ntpac.,.crawis ''e'v:prenicosurefloor)-
0) Top of the next high-00100e
c) Rotibm of thOjow,esift0*`ohtaI structural - memoik (VZones-only).
d) Attachedg-aragq#poo.., lw-
db 0. Wornent.....
e) LoWestvie�iali6k;VOW
-.00.thebUilding
Mescritralype Ofi,Uipment to Comments)
f) LqwOst;3d.#a`- .41.gratis (IAG)
1.111
gpotj,
gy lirghest'edjacent(ft(itshe+j glade (NAG)
,Onder Construction"' 0 Finished Construction
APJA'E, ARM-Mb, APJAH, ARIAO. Complete items C2.-"
Check the measurement' used.
R&6_
264,leei
.0 meters (Puerta:k1co�OnO
meters (Puerto Rico only)
171moters (Puerto Abm ONY)
21, as
:feet
0 meters (Puerto Rico.only)
JR-ifidt.-O
meters (Puerto Rico -only)
746z
;fffogt-
0 iftters.( I Puerto Rico co only)
Wq- .O,,
R F, CERTIF[CATI
Mv.
This celtificatior is to lang d sealed b'*W surveyor, bd' Offidzod;by la-Owto d;SU :OrArch
infbonati6nt c6*46k0k 00h1-# -i.
Ate represents my best etTorfs
., r 16
Ividerstaridth Mtat"b unfsha 1a byfine orimpfisohMMLOOOOOO U.S.. -Coda; SeclForrIQ. 1;
0 Check here.if comrrrents are proVid, ff.b4ck:vfform,
CertlfIeVsN'a'm*e .tames XT7—n' 44
5se.NUMber 3435
Title Professional .Surveyor :and Mapper Cd M'pany Name CUIp#pper&TSrpenihO,Inc
Address 29MO.dtlj-95FStreet; City Ft,Pierce '.Stdt6,Fl ZIP Code 34982
D!e �:04 . -01-2009 TOphone:'772 537 ta
'IMOt1"Ai'C to tl> esepacs cop; �e t spoidfng 'rforrt)ation frotri Sedan . P For insurance Cbrnpany tie:
Burldrlh Strest�;ddress+(u►olucingppt; Una; Ssurti, ;; ror $Idg. No.) or P.O. IZbute and eox:Na: Porrcy.Numtter
BOO WATE t;?OfVGitVAS
Crty, FQR7 PIERCE State FL ZtP Code_ 34g49; ebiripany. NAIC Number
SECT tQl�f DSC1fVYO, EIyJNEER, OR ARCy!'fEGT LEITIFICATION:°(GON7`INUtc`gj:
t;apy baKWd6i-of this Elevation flm6ate for ( j cammtrntEy ofiicialx, (2j inSurancs agenticots parry, and ( tuilding, owner
Comments i Latrtu+etC:ongrtuds.was obtetrtfroimi andrrefd Gf*.S unit.
2..LoWest±:tevatrorrof mac'Iifiieny ts,AG..Pad located in the 4`" floor.
Signa# :e Date 04-0t 2409
,. > Ctteekhere if attachments
SECTtt7N;E $tlti t lfwtG El. 'ATtON l I p12 IfA '[ON4SURVEY NOi`.00*00WOR'ZflNE AO AI D ZO E A {WITHOUT BEE}
For Zones AO and A (wcptt out 8F ), complete lterlas tE 5 Ifthe Certificate is rntendet# #o suf5pprt a LQN(A or LOMR-F request;: corrrpiefe:Seetions A, B,.
and G ;For ftems'E t E4 use n�turat grade;; if available ChecR:#he measurement used' 1r'Pue to ca only,: enter meters.
e.
E1 P.rovide ef�vahon tnformatton for the following ?ncl check the appropriate boxes to sttoW"wt ether"the elevation is above.ar• below the highest adjacent
grade (HAG} and Etta lowest adjacent grade (LAG)
a) Top of tiottorrr flavor (tnctGding basemeht, cravrl spa ,.orenclosure) is. Ej feet Q'. meters Q::above or Q below the HAG.
b}:Tap of bottom floor Unctudrtg baserrtent, erawsj�ace; or enclosure) is _ _,. Q feef ureters Ci above or below the-t AG.
F2. For Mildmg Diagrams (i-g Wifh permanent flood openi4a provided or m-Section A Items IfYari'a f9 (see page 8 of instntcbons), the'ne>rt Higher floor
(elevafiari:G2 b in.tlie diagrams) of the buridLrig is ❑ feet ❑meters Qboye. br ❑ beloinr the HAG:.
E3 Attached garage (top of slab}.'is ❑feet Q meters ❑ above or Q below file HAG.
E4. ,op
.of ptaifotm of n achi`eryr:and/or equipment semcrng the building is Q feet Q:msters Q above or Q beiowthe HAG.
ES: Zone AQ,6nty: If.no:Aood depth number is'avaifabie� is th[e #ap.ofthe bottom flodt'okVO.ted•,inaccoidance with the community's hoodplain-management
ordinance? Q' Yes j] IJa .:Q Unknown. The rocal'official. must certtiy tiiisiofQrmatidit tn;Seeton G.
SEtT[QN, PR(Pt[EIA1.(O OWNER'S aEPISE(iTIVE). GERTIPI+sT10N
The property owner or ovJ66e auto"ottzsd r epresentatarie who completes Sections A Pj, and E for Zane A (+tuOO t a F)rMA issued or coir►munity: issued BFEj
or zone AO mOst sign here I re st$temertfs in Seci oft �l, ca d Fare corrraci io t/ra;:tiiast of nj? krrotkrte` lge:
PropotyOwner's or Owner's Au[tiurrzed Representattverg, Na me
Address City State ZIP Code
Signature Date Telephone
Comments.
Sf~CT`tON �
and"G of thas FJsvatian CerUTicate Gomj�fete the app table tini(?}'and sign below. Che` ifie rnaasurement us ' an: ems.. , .an
Gi. ❑ The information rneefion G was:tatcen framrothet daticumentatiort that has been signed;and:§ealed by a Iicensel;surve}TQr,. engineer, or architect who
...
is authorized-by.=lo* to oe"rtify elevn.at ort tnfotittatio- t indlcate the. source and hate of the°etevation data in the Comments:are.a :below.)
G2. j] A commundy ofiieiai campJoted.Section E;for a building :located in Zone A (without a FEIVIA-issued or community=issued BEE) or.Zone AO.
G3. Q The•follou+ttng Info ided for community tioodpiairi;manageriient-purposes.
G4. Permit WOO G$ , data Pemtit Issued ace ' D.ate: Cert'riicate-Of Corinplianc ,0cdOpaney issued
4?
7 This permit has,been issued for:. New Construction Q Sub's*Wl Improvement
Gs Ereva flan of as -built to ra st fCoor Crnclutlxng: fsa en aetit) ofthe-building C3 fast j]�m ters (PR) ;Datum .
#ooQeet�me#ersPDatumG9 $FE or (inAke
t ocai Officin. 1Varrle Tate
Ca�mnnty Nana: Terephahe.
:ignattire Date I
Corn,mea s
Q: Check here if attachments
FEMA; Form 81-M Patin ary=6 Replaces all previous editionsI
4 Y I
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
4808 WATERSONG WAY
City FORT PIERCE State FL ZIP Code 34949 Company NAIC Number
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 View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
FRONT VIEW
�'Suilding Photographs
Continuation Paae
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and/or.Bldg. No.) or P.O. Route and Box No. Policy Number
4808 WATERSONG WAY
City FORT PIERCE State FL ZIP Code 34949 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."
RIGHT SIDE VIEW