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Home My WebLink AboutElevation Certificate 8-4-16DEPARTIV' 017 HOMELAND SECURITY (� ✓ �� - � ��/ Federal En��._,.pncy Management Agency f ��y _ Ca E''LEVATION CERTIFICATE OMB Control Number:1660-0008 IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 Expiration: 11/30/2018 Copy all pages of this Elevation Certific::a and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION < - PROPERTY INFORMATION FORM INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: HAROLD MELVILLE A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Box No. Number: 2302 GRAND OAK AVE. City FORT PIERCE State FL Zip Code 34981 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 3404-712-0002-0009 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27 22 29 Long. -80 20 38 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 1A A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 400 sq ft b) Number of permanent flood openings in.the N/A b) Number of permanent flood openings crawlspace or enclosure(s) within 1.0 foot in the attached garage within 1.0 foot N/A above adjacent grade above adjacent grade c) Total net area of flood openinr,: 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 (:: No d) Engineered flood openings? C.-'Yes () No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State FL` ST. LUCIE COUNTY 120285 ST. LUCIE B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) 12111 CO276 J Revised Date AE (Zone AO, use base flood Apr 17, 1981 Feb 16, 2012 depth 7 ' B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: [; FIS Profile (.) FIRM () Community Determined r Other/Source: B11. Indicate elevation datum used for BFE in Item B9: (`NGVD 1929 t• NAVD 1988 (j Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? (-,Yes (?; No Designation Date: ()CBRS (`OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: r,, Constructon Drawings" (';Building Under Construction' Q Finished Construction C2. Elevations - Zones Al - A30, AE, AH, A (with BFE), VE, V1 - V30, V (with BFE), AR, AR/A, AR/AE, AR/AI - A30, AR/AH, AR/AO. Complete Items C2.a -li below according to the building diagram specified in Item AT In Puerto Rico only,.enter meters. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: LOCAL BENCH•�IARK Vertical Datum: NAVD 1988 Indicate elevation datum used for the; levations in items a) through h) below. C` 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) 8.6 - (t1 feet (,, meters b) Top of the next higher floor N/A - (t,, feet (j meters c) Bottom of the lowest horizontal structural member (V Zones,only) NIA - (:-feet (7) meters d) Attached garage (top of slab) 8.0 - Ot feet Cj meters e) Lowest elevation of machinery or equipment servicing the building 8.0 " - (; feet (-j meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 7.2 - !:•feet t meters g) Highest adjacent (finished) grade next to building (HAG) 7.5 - (!feet () meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A - C�) feet meters (: structural support FEMA Form 086-0-33 (7/15) ` Replaces all previous editions. rage a or 10 ELEVATION CERTIFICATE DMB Control Number: 1660-0008 Expiration: 11 /30/2018 2302 GRAND OAK AVE, FORT PIERCE FL 34981 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 maybe punishable by fine or imprisonment under 16 U.S. Code, Section 1001. Were latitude and longitude in Section A ® Check here if attachments. provided by a licensed land surveyor? Yes t^j No Certifier's Name License Number RICHARD C. LAVENTURE FLORIDA 5209 PLACE Title Company Name 5EAi PRESIDENT LAVENTURE & ASSOCIATES, INC. E-IEr2t_ Address City State Zip Code 774 W. MIDWAY ROAD FORT PIERCE FL 34982 Signature Date / Telephone �1111 C +1 (772) 398-6430 Copy both sides of 14 Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. Comments (including type of equipment and location , per C2(e), if applicable)" • A/C Pad = 8.0' Signature Date B yAl SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), c,-)mplete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1 -E., 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, crawlspace, ( feet (` meters ❑ above or ❑ below the HAG. or enclosure) is b) Top of bottom floor (including basement, crawispace, _ ;feet ()meters ❑ above or ❑ below the LAG. or enclosure) is E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8 -9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is - Q feet l ; meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is - 0 feet C, meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment - servicing the building is (:feet ( meters E] 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 roust sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name: Address City State ZIP Code Signature Date Telephone Comments ❑ Check here If attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. r•dyo Y OMB Control Number: 1660-0008 Expiration: 11/30/2018 , 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 GB - 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 i G8. Elevation of as -built lowest flow- (including basement) (feet (' meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building - feet t meters Datum site: G10. Community's design flood elevation: (jfeet (`meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments i i ❑ Check here If attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 5 of 15 BUILDING PHOTOGRAPHS See instructions for Item A6 OMB Control Number. 1660-000B Expiration: 11/30/2018 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. 2302 GRAND OAK AVE. Policy Number: City FORT PIERCE State FL Zip Code . Company NAIC 34981 Number. If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. ` PLEASE SEE ATTACHED FEMA Form 086-0-33 (7/15) Replaces all previous editions. Page 6 of 15 � r r ` t 4Z rV�a�.a � 1Fn{yn6.giN�#Xa: 4 , � .`.� �{ ; - i1'�'µ •t� '� �' , ¢) � } _ 4 x�, ``u I s , RIM .t �'^ ,SHY .{' S� !� J` �/'•b Y' lrllF � S sc• 7 rho '7 iPf • : � rd i �ri rLi ti N cJ at,. 17 IQ Iz. IA It U, Rtp I IA P�l- 7 frV TZ