HomeMy WebLinkAboutElevation Certificate 12-9-08U.S. DEPART'JENT OF HOMELAND SECURITY CLCYH 1 IVIV VCR 1 1rmoj% 1 C I plres February 28. 2009 I
FederalZ-merdencyManagement Agency
Nationa[Flood Insurance Program �.. )rtant: Read the instructions on pagec) I VA -A e j o Vie/_ pre'r
SECTION A- PROPERTY INFORMATION ForinsuranceCAmipanyUs;
Al. Building Owner's Name Ronald K. Rupp Poycy Nktiiilser '
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. C'otnpatty NAIC Nurn#rert
4917 WATERSONG WAY
City FT. PIERCE State FL ZIP Code 32949 rC r A
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) l `
LOT 23, WATERSONG SUBDIVISION
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat 27 23' 20.45"N Long. 80 15' 36.18'1N 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 Diegmm Number 1
A8. Fora 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 390 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
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2. County Name B3. State
120285 UNINCORPORATED I ST. LUCIE FLORIDA
B4. Map/Panel Number
65. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood'
69. Base Flood Elevation(s) (Zone
Date
Effective/Revised Date
Zone(s)
AO, use base flood depth)
12144C0194
G
6130199
11/4/92
- AE
T
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) NIA
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)
C1. 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 Al -A30, AE, AH, A (with BFE), VE, V1 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 A7.
Benchmark Utilized Y Vertical Datum NGVD29
Conversion/Comments N
Check the measurement used.
a) Top of bottom floor (including basement, crawl space, or enclosure floor)_
7..63
® feet
❑ meters (Puerto Rico only)
b)
Top of the next higher floor
18.43
® feet
❑ meters (Puerto. Rico only)
c)
'Bottom of the lowest horizontal structural member (V Zones only)
NA.
❑ feet
❑ meters (Puerto Rico only)
d)
Attached ga..ge (top of slab)
7.07
® fast
❑ metsm (Puerto Rico only)
e)
Lowest elevation of machinery or equipment servicing the building
18.43
® feet
❑ meters (Puerto Rico only)
(Describe type of equipment in Comments)
f)
Lowest adjacent (finished) grade (LAG)
7.1
® feet
❑ meters (Puerto Rico only)
g)
Highest adjacent (finished) grade (HAG)
7 4
® 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
Building Photographs
See Instructions for Item A6.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Policy Number
4917 WATERSONG WAY
City FT. PIERCE State FL ZIP Code 32949
Company NAIC
If using the Elevation eertificate to obtain N€IP 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 ELEVATION
REAR ELEVATION
Building Photographs
Continuation Pace .
For Insurance Company
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
4917 WATERSONG WAY
City FT. PIERCE State FL ZIP Code 32949 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 Mew"; and, if required, "Right Side View" and "Left Side View."
SIDE ELEVATION
SIDE ELEVATION