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Home My WebLink AboutElevation Certificate 11-3-16S."DEPARTMENT OF HOMELAND';,_, �',URITY OMB No.1660-0008 Federal Emergency Management Agency 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: CLEWS & CHANDLER A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 1299 NETTLES BLVD. City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°17'04.6" Long.-80°13'10.6" 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 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 299 sq ft b) Number of permanent flood openings in the crawlspace 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 ❑x 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 B1. NFIP Community Name & Community Number B2. County Name B3. State UNINCORP 120285 ST. LUCIE Florida 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 VE 10.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ 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 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 C 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 e d Box No. Policy Number: City State ZIP Code Company NAIC Number [a -39 957 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Uhder 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 AT In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 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. 43 Q feet ❑ meters b) Top of the next higher floor 13. 26 ❑x - feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) 10. 0 0 feet ❑ meters d) Attached garage (top of slab) N/A. ❑ feet ❑_ meters e) Lowest elevation of machinery or equipment servicing the building 11. 35 ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4. 1 0 feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.2 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4. 3 0 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. / certify that the information on this Certificate represents my best efforts to interpret the data available. ) 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? ❑x Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number EARLE R. STARKEY 004459 Title PROFESSIONAL LAND SURVEYOR Place Company Name ACCURIGHT LAND SURVEYING INC. Seal Here Address 1501 DECKER AVENUE #419 State ZIP Code STUART Florida + 34994 Signature Date . Telephone (1/03/2016 772-260-0091 Copy all pages of this 6yedon Certificate and ail 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) A8-A THE ENCLOSURE BELOW WAS CONSTRUCTED WITH BREAKAWAY WALLS, THERE IS NO STEEL OR CONCRETE FILLED CELLS WITHIN SAID WALL. C2-E A/C PLATFORM FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 I IMMEL-I'm % * in i I U44 0