HomeMy WebLinkAboutElevation CertificateU.S. DEPARTMENT OF HOMELAND S-c:W`RITY 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.
McGHEE
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
Company NAIC Number.
City State ZIP Code
JENSEN BEACH Florida 0 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 689, NETTLES ISLAND PROJECT, SECTION 2
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) STORAGE ROOM
A5. Latitude/Longitude: Lat. 27°17'09.8" Long. 80°13'13.5" 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.
AT Building Diagram Number 1 B 0
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawispace or enclosure(s) 111 sq ft
b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A8.b 400 sq in
d) Engineered flood openings? ❑x Yes ❑ 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 / 12Q285
ST. LUCIE
Florida
B4. Map/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
69. Base Flood Elevation(s)
Number
Date
Effective/
Zone(s)
(Zone AO, use Base Flood Depth)
Revised Date.
12111 C 0311
J
02/16/201 Z
02/16/2012
AE
6.0
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:
B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 x❑ NAVD 19$8 ❑ 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: N/A ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
DMB 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.
& S q r-z r rt_it S [3 o u L- rz VA.1z L>
City State ZIP Code
Company NAIC Number
SECTION. C — BUI).DING 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, ARIA, 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: N.A.V.D. 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, crawlspace,'or enclosure floor) 4.99 ❑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 o� 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) 4A ❑x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4.7 ❑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? Yes ❑ No ❑x Check here if attachments.
Certifier's Name License Number
•J �, G t 3 t O .."t 5- o l
EARLE R. STARKEY 004459
Title
PROFESSIONAL LAND SURVEYOR
Race
Company Name
ACCURIGHT LAND SURVEYING, INC.
'
Address
1501 S.E. DECKER AVENUE, UNIT 419D
City Pate ZIP Code
STUART Florida 0 34993
j?S it 00/4 %4 S 9
Date _,. ' Telephone Ext.
05/30/2018 (772) 286-7694 N/A
Copy all pages of this Elevation 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)
A8(b) SMART VENT MODEL NUMBER 1540-520
FEMA Form 086-0-33 (7115) Replaces all previous editions. - vorm rage z or o
t__A8n11ding Photographs
Capon Page
suKHrIg MW Anse (mM&G APL, Unit, Suite, and/or 81dg. No.) or P.O. Route and Box No. PcBcy.nri,mbec
,689 NETTLES BLVD.
City state ZIP Code 11140W,.. .
JENSEN BEACH FLORIDA349.97
If submitting more photographs than wilt fit on the preceding page, affix the additional photographs below. Identify W
photographs with: date taken; `Front View' and `Rear lriew'; and, if required, "Right Side VieW and `Left Side View."
FRONT 05/30/2018 SIDE 05/30/2018
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