HomeMy WebLinkAboutElevation CertificateEPARTMENT OF HOMELAND SECURITY ELEVATION, CERTIFICATE. OMB' No. 1660-0008
feral Emergency Management Agency Expires February 28.2009
National Flood Insurance Program -important: Read the instructions on pages 'r -;o. 0 O a Z--a G */', ;7
SECTION A - PROPERTY INFORMATION For (nsuxaik 4ri�ttp'anry5e ,
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ?ot�arllAlG
4917 WATERSONG WAY '.,..�.s
City FT. PIERCE State FL ZIP Code 32949
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
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 16 36.18'.9N 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 NIA 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 62. County Name B3. State
120285 UNINCORPORATED ST. LUCIE 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)
12111CO194
G
6/30/99
11/4/92
AE
7'-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)
1311. 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` I@ 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.
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.
5.31
ID feet
❑ meters (Puerto Rico only)
N/A.
❑ feet
❑ meters (Puerto Rico only)
N/A.
❑ feet
❑ meters (Puerto Rico only)
N/A.
❑ feet
❑ meters (Puerto Rico only)
N/A.
❑ feet
❑ meters (Puerto Rico only)
4.4
® feet
❑ meters (Puerto Rico only)
5.4
® 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 cettifyelevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
® Check here if comments are provided on back of form.
Certifier's Name DAVID M. TAYLOR License Number 5243
Company Name
2 /1 I'- City VERO
PLACE
. = SEAL'
3/26/08 Telephone (772)-564-8050 I I
IMPORTANT: In these spaces, copy the Wsponding information from Section A.
Building Street Address (including Apt., Unit, Suit . d/or Bldg. No.) or P.O. Route and Box No.
4917 WATERSONG WAY
City FT. PIERCE State FL ZIP Code 32949
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments Job #6151 BASED ON FORMB L CATION SUREY PERFORMED 3/25108
�°— ❑ 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 El-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.
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 (HAG) 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 0 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 (seepage 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'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. 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.
'133. ❑ The following information (Items G4.-139.) Is provided for community floodplain management purposes.
IG4. Permit Number I G5. Date Permit Issued I 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: _0 feet ❑ meters (PR) Datum
G9: BFE or (in Zone AO)' depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
Local Official's Name Tale
Community Name Telephone
Signature Date
Comments
F1 Check here if attachments