HomeMy WebLinkAboutElevation Certificate 11-08-16r
1U)4- (M
U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008
Federal Emergency Management Agency I Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Policy Number:
LITYNSKYJ
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
1308 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH Florida El 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 1308 NETTLES ISLAND PROJECT SECTION 2
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°17'04.4" Long.-80*13'11.8" 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 8
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of-crawlspace or enclosure(s) 844 sq ft
b) Number of permanent flood -openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 6
c) Total net area of flood openings in A8.b 1200 sq in
d) Engineered flood openings? ❑x Yes ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garage 188 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A9.b 400 sq in
d) Engineered flood openings? ❑x Yes ❑ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORP 120285
ST. LUCIE
Florida El-
B4. Map/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood Zone(s)
B9. Base Flood Elevation(s)
Number
Date
Effective/
(Zone AO, use Base
Revised Date
Flood Depth)
12111 C 0311
J
02/16/2012
02/16/2012
-AE
7.0
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
1311. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
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:
City State ZIP Code
Company NAIC Number
0 34aS7
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ 'Construction Drawings* ❑ Building Under Construction* x❑ 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, 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: 94 77 A04 FLDT Vertical Datum: NGVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 4.4 0 feet ❑ meters
b) Top of the next higher floor 8. 1 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters
d) Attached garage (top of slab) 4. 65 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 9. 1 0 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 4.2 ❑x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4. 3 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑ feet ❑ meters
structural support
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.
l 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 rive or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑x Check here if attachments.
Certifier's Name License Number
EARLE R. STARKEY 004459
! ^-a -7
Title
PROFESSIONAL LAND SURVEYOR
Place
Company Name
ACCURIGHT LAND SURVEYING INC.
Seal
Here
Address
1501 DECKER AVENUE #419
�t- Sg
City State ZIP Code
S Florida 0 34994
j % 0 a 'Z a
f
Signa Date • Telephone
91 /08/2016 772-286-7694
Copy all pages of this Elevation Certi ca an a a r (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
A8-D & A9-D FLOOD VENT MODEL #1540-520 C2-E A/C PLATFORM
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
Building Photograp
See Instructions for Item A6.
- - - - - For Insurance Company Use.
Building Street Address Cmduding Apt., Unit, Suite, anWor Bldg. No.) or P.O. Route and Box No. Poky Number
1308 NETTLES BLVD,
City ZIPJENSEN BEACH state FLORIDA 43 9e57
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 11/08/2016 REAR 11/08/2016
r
�Ml
Rv
1 3 4 a, i y y rcrt r
iu x 3 z' per L j J rr�
;Yt
Mon
y w
iz +,
f
4. 1� �i• � "�� �r�i t.
try i
Fi T et {
M 3A,•
tjr
SIDE 11/08/2016
TABLE 1—MODEL SIZES
MODEL NAME
MODEL NUMBER
MODEL SIZE (in.)
COVERAGE (sq. ft.)
FloodVE-NT
200
SmartVENT°
1540-510
153/4' X 73/4"
200
FloodVENT° Overhead Door
1540-524
153/4' X 73/4"
200
SmartVENT® Overhead Door
1540-514
153/4" X 73/4"
200
Wood Wall FloodVENT®
1540-570
14" X 83/4"
200
Wood Wall FloodVENT° Overhead Door
1540-574
14" X 83/4"
200
SmartVENT® Stacker
1540-511
16" X 16"
400
FloodVent® Stacker
1540-521
16" X 16"
400
For SI: 1 inch = 25.4 mm; 1 square foot = mZ