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HomeMy WebLinkAboutElevation CertificateTAC7- . G ("'��5 7/ 9 U.S. DEW, -� UENT OF HOMELAND SECURIT`! .ELEVATION CERTIFICATE OMB No. 1660-0008 Federpl'Emergency Management Agency Expires February 28. 2009 National Flood Insurance Program Important Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION J^or Insurance Compaq Use Al. Building Owner's Name .RONALD K. RUPP Poltcy Nurhber A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route _and Box No. Ggmpany IVAtiG Nuirrber ,4932 WATERSONG WAY City FT. PIERCE State FL ZIP Code 32949 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 61, WATERSONG SUBDIVISION A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 27D23.324N Long. 0801115.580W 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 1 A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage 394 sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b Q sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 52. County Name B3. State 120285 UNINCORPORATED I ST. WCIE FLORIDA B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood.Elevation(s) (Zone Date . Effective/Revised Date Zone(s) AO, use base flood depth) 12111 C0194 G 06/30/99 11 /04/92 AE 8 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 (Describe) B11. Indicate elevation datum used for BFE in Item 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ®Yes []No Designation Date 1983 ® CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Ai 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-g below according to the building diagram specified in Item AT Benchmark Utilized Vertical Datum Conversion/Comments a) Top of bottom floor (including basement, crawl space, 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 in Comments) f) Lowest adjacent (finished) grade (LAG) g) Highest adjacent (finished) grade (HAG) Check the measurement used. 8.5 ® feet ❑ meters (Puerto Rico only) -99.4. ® feet ❑ meters (Puerto Rico only) N/A. ED feet ❑ meters (Puerto Rico only) 7.9 ® feet ❑ meters (Puerto Rico only) feet ❑ meters (Puerto Rico only) 7.5 ® feet ❑ meters (Puerto Rico only)' 8.2 ® feet ❑ meters (Puerto Rico only) 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. 1 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. Certifiees Name DAVID M. TAYLOR License Number 6243 Title PROFESSIONAL SURVEYOR Company Name MASTELLER, MOLER, REED & TAYLOR, INC. PLACE �. �FL IMPORTANT: In these spaces, copy the a ponding information from Section A. FQl*frt uragce Corapar3�r lfs Building Street Address (including Apt., Unit, Suite, or Bldg. No.) or P.O. Route and Box No. t?obcyufJernber ;' 4932 WATERSONG WAY City FT. PIERCE State FL ZIP Code 32949 Gofipeny.1mtC Number SECTION D --SURVEYOR, ENGINEER; OR ARCHITECT CERTIFICATION (CONTINUED) - Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. Comments Pro ct #6148 item 2e is an a/c pad. garage square footage is estimated. - 50e Signs Date 1/12108 ❑ Check here if attachments 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 El-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 (NAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 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 and G of this Elevation Certificate. Complete the applicable item(s) and sign below. lain management ordinance can complete Sections A, B, C (or E), the measurement used in Items G8. and G9. 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: G9.) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit.lssued 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 (PR) Datum G9. 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