HomeMy WebLinkAboutElevation Certificate 2-17-17dP' Q.S. DEPARTMENT OF HOMELAND(' ,L fY JOMB No.1660-0008
ederaLEmergency Management Age°:�;J I Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Importarit: 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
_-. _ __.._
�A�6ui i(d"ng Owne s ame
_Poiicy-Number^�--=— —
JOSEPH & PATRICIA HURLEY
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
1303 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH Florida 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 1303 NETTLES ISLAND PROJECT SECTION 2
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°17'05.3" Long.-80°13'11.9" _ 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 5
A8. For a building with a crawispace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A sq in
d) Engineered flood openings? ❑ Yes Z No
A9. For a building with an attached garage:
a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑ Yes ❑x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
131. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORP 120285
ST. LUCIE
Florida
B4. Map/Panel
B5. Suffix
66: FIRM Index
B7. FIRM Panel
B8. Flood Zone(s)
B9. Base Flood Elevation(s)
Number
Date
Effectivel
(Zone AO, use Base
Revised Date
Flood Depth)
12111 C 0311
J
02/16/2012
02116/2012
AE
6.0
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. 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 (7115) Replaces all previous editions. Form Page 1 of 6
-- r OMB No. 1660-0008
ELEViOON CERTIFICAT { -Expiration Date: November-.30, 2018
IMPra_r2TANT: In these spaces, -copy the corresponding -information from Section A. - FORINSURANCE:COMPANY�USE
Buila'Ing Street Address (includir gApt:; Unit; Suite, and/or Bldg. No.) or P.O. Route and Box No. ?Policy Number:`='--,-' ','_7
City State ZIP Code Company NAIC Number
.Jer4SF,#.I geAc,1-4 FL o R 1 IZA 3 y 9 SZ
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, VI-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 FDOT Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 x❑ 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, crawispace, or enclosure floor) 9.2
x❑ feet
❑ meters
b) Top of the next higher floor, N/A.
❑ feet
❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A.
❑ feet
❑ meters
d) Attached garage (top of slab) N/A.
❑. feet
❑ meters
e) Lowest elevation of machinery or equipment servicing the building 6.8
❑x feet
❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 4.1
❑x feet
❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4. 2
❑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.
I 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.
Were latitude and longitude in Section A provided by a licensed land surveyor? FX] Yes ❑ No ❑x Check here if attachments.
Certifier's Name License Number J e{3 I's Z.SSS - O 1- fl
EARLE R. STARKEY 004459
Title
..-PROFESSIONAL-LAND SURVETYOR - - -
Company Name Place
ACCURIGHT LAND SURVEYING INC. Seal
Address Here
1501 DECKER AVENUE #419
City State ZIP Code D Z 1-% "T i Z o 17
STU Florida 34957 S of
Signature Date Telephone
02/17/2017' 772-286-7694
Copy all pa es o evation Certificate and all attachments for (1) community official, (2) insurance, agent/company, and (3) building owner.
Comments (including. type of equipment and location, per C2(e),. if applicable)
C2 E A/C PLATFORM
x� r
FEMA'Form 086 0-33. (7/15) Replaces all previous :editions. Form Page
MEN
0.6 rap
BUIldfuth
s'Item A6
For If"imme cornoany U.M.
(iram..g Apt.,
Pt, or P.Q. Rowe and Box No. PoAcy Number
NETTLES BLVD.
- - ------ ---
State . AP Code.
SSEN --- REACH, FLORIDA 34957
Elevation
_C
e0ca
t3 to vl tarn �IF
"P" g."to
'
ns for Item
with ;date taken; `Front vew' and "REar Vieu+�'; and, if required;.
0 A:.en* P'togrop photographs tfian wilt. fit. on it�i$ paw,.. cese the Cnntinuaiioa ightdL'f'�vifMitbnqn� Page,�RON 02 1772017
SIDE 02/17/2017