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HomeMy WebLinkAboutElevation Certificate,/ M/ U.S. DEPARTMENT OF HOMELAND SECURITY ' t VA I I V N t:tK l I -JUA I Lk- ' FEDERAL EMERGENCY MANAGEMENT AGENCI, OMB No. 1660-0008 National FloodlnmranceProgram Important• Read the instructions on page`s"i-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION Al. Building Owner's Name CLEWS & CHANDLER A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1299 NETTLES BLVD City-JENSENBEACH State FL ZIP Code 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) , LOT 1299, NETTLES ISLAND PROJECT SECTION 2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°17'04.6" N Long. 80°13'10.6" W 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 6 A8. For a building with a crawlspace or enclosure(s): A9. Fora building with an attached garage: a) Square footage of crawlspace or enclosure(s) 299 sq It a) Square footage of attached garage NIA sq It b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b , N/A sq in d) Engineered flood openings? ❑ Yes 0 No d) Engineered. flood openings? ❑ Yes 0 No SECTION B FLOOD INSURANCERATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State UNINCORP 120285 ST. LUCIE FL B4. Map/Panel Number B5. Suffix .136. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base,Flood Elevation(s) (Zone 12111 C 0311 J 02/16/2012 Effective/Revised Date "Zone(s) AO, use base flood depth) 1 02/16/2012 AE & VE 7.0 & 10.0 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile © 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 �BRS) area or Otherwise Protected Area (OPA)? i El Yes 0No Designation Date: _ ' CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. 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. 1 C2. Elevations -Zones Al A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, AR/A1A30, 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: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 © 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) 4.433 0 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) ' 11.9 0 feet ❑ meters d),Attached garage (top of slab) N/A., ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building N/A_- ❑ feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.2 0 feet `. ❑ •meters g) Highest adjacent (finished) grade next to building (HAG) 4.1 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support NIA._ ❑ feet ❑ meters SECTION b - 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. ❑X Check here if comments 'ate rovided on back of form. p ,Were latitude and longitude in Section A provided by -a" . ElCheck here if attachments., licensed land surveyor? N Yes $❑ No Certfier's Name EARLE R. STARKEY License Number 004459 Title PROFESSIONAL LAND SURVEYOR ....0 any Name ACCURIGHT LAND SURVEYING INC. Add DECKER AVENUE 'City .STUART State FL ZIP Code 34994 Sig Date 04/05/2016 Telephone 772-286-7694 FEMA Form 086- See reverse side for continuation. 104s41.'017-,UC rPLACE S , 016 r PL.S #4459 Replaces all previous editions. ELEVATION CERTIFICATE. Daae 2 IMPORTANT: In these spaces, copy the ce, ;ponding information -from Section A. - FMNWkMS E MP Y-USE, Building Street Address (including Apt., Unit, Suite; ana or Bldg. No.) or P.O. Route and Box No. 1299 NETTLES BLVD. City JENSEN BEACH State FL ZIP Code 34957pe�tCfi 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 C2-A THE ENCLOSURE IS MADE OF FRANGIBLE WALLS Signature Date 04/05/2016 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) l 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 Section's A, B, and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. 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, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 91see pages 8-9 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—G10. In Puerto Rico only; enter meters. 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. G3. ❑ The following information (Items G4-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued 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: _ _ ❑ feet ❑ meters Datum _ G9. BFE or'(in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum _ Local Official's Name'- - Title Community_4ame' -- Telephone Signature - Date Comments ❑ Check here if attachments. a U.S. DEPARTMENT OF HOMELAND SECURITYCY C VA I 1 V N Cali 11I" I C:A 1 t OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGEN National FloodlnsuranceProgram Important: Read the instructions on pages 1-9. Expiration Date: July 31% 2015 SECTION A - PROPERTY INFORMATION 'f► 1> i ;1 Owner's Name CLEWS & A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No: �. " 1299 NETTLES BLVD �'"... ._ City JENSEN BEACH State FL ZIP Code 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 1299, NETTLES ISLAND PROJECT SECTION 2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) _ RESIDENTIAL A5. Latitude/Longitude: Lat. 27°17'04.6" N Long. 80°13'10.6" W Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 6 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 299 sq it a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes 0 No d) Engineered flood openings? ❑ Yes 0 No SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State UNINCORP 120285 1 ST. LUCIE FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111 C 0311 J 02/16/2012 Effective/Revised Date Zone(s) AO, use base flood depth) 02/16/2012 AE & VE 7.0 & 10.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: 1311. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: _ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date: _ Lj CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* 0 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, 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 88 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) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) 4.43 13.26 11.9 d) Attached garage (top of slab) N/A., e) Lowest elevation of machinery or equipment servicing the building N/A... (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 0 feet ❑ meters 0 feet ❑ meters 0 feet ❑ meters ❑ feet ❑ meters ❑ feet ❑ meters 0 feet ❑ meters 0 feet ❑ meters ❑ feet ❑ meters SECTION b -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. 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a El Check here if attachments. licensed land surveyor? 0 Yes El No Certifier's Name EARLE R. STARKEY License Number 004459 Title PROFESSIONAL LAND SURVEYOR -C any Name ACCURIGHT LAND SURVEYING INC. Add DECKER AVENUE -City ,STUART State FL ZIP Code 34994 Sig R Date 04/05/2016 Telephone 772-286-7694 FEMA Form 086- See reverse side for continuation. 1046-01 `o1-UC PLACE PLS #4459 Replaces all previous editions. J. ELEVATION CERTIFICATE. Daaa 2 "", IMPORTANT: In these spaces, copy the ci�,_ __;ponding information from Section A. 1 I S1JF3 NCE 0PiYIatSE • `. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ocN(nr 1299 NETTLES BLVD. 5`�� ;._., City JENSEN BEACH State FL ZIP Code 34957arripsCfutrbar 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 C2-A THE ENCLOSURE IS MADE OF FRANGIBLE WALLS Signature LE Date 04/05/2016 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 E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Section's A, B, and C. For Items El-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. 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, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 91see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or [J 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-G10. In Puerto Rico only; enter meters. 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. G3. ❑ The following information (Items G4-G10) is provided for community floodplain management purposes. G4. 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: _ _ ❑ feet ❑ meters Datum G9. BFE or.(in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters Datum _ G10. Communitys design flood elevation: ❑ feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments.