HomeMy WebLinkAboutElevation CertificateU.S. DEPARTMENT OF HOMELAND._ �:URITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION -CERTIFICATE
Important: Follow the instructions on pages 1-9.
l-710-U1 ffly
OMB No.1660-0008
Expiration Date: November 30, 2 118
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
WALKER
A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number.
Box No.
429 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH Florida 0 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 429 NETTLES ISLAND PROJECT SECTION 2
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessary, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°1T10" Long. 80°13'10.7" 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 El
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A 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 0 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 WA
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
134. Map/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation s)
Number
Date
Effective/
Zone(s)
(Zone AO, use Base �lood Depth)
Revised Date
12111C 0311
J
02/16/201Z
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:
1311. Indicate elevation datum used for BFE in Item B9: ❑ 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: N/A ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
OMB No.1660-0008
J. ' Expiration Date: November 301
2018
ELEVATION CERTIFICATE
IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE
Builds g Street Addre (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route'and Box No. Policy Number:
�,� �L-G�t-'v Company NAIC Number
State zip Code
City
S%
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, V1 V30, V (with BFE), AR, ARIA, ARIAE, 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.
g,1 3 9 feet ❑meters
a) Top of bottom floor (including basement, crawispace, or enclosure floor) N/A ❑ feet ❑ meters
b) Top of the next higher floor NIA ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) NSA ❑ feet ❑ meters
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building 6.8 [xj feet ❑ meters
(Describe type of equipment and location in Comments) 4.1 0 feet ❑ meters
f) Lowest adjacent (finished) grade next to building (LAG) 4.7 0 feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4.0 ❑x feet ❑ meters
structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed andep a e represent my best efforts,or architect authorize to interpret the data available. I undlaw to erstand and thelevaat any faon lsetion.
1 certify that the information on this
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ No Check here if attachments.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑Yes
License Number 27 Z I - G X - O k
6;eruners vVG,I,G 004459
EARLE R. STARKEY
PROFESSIONAL LAND SURVEYOR
ACCURIGHT LAND SURVEYING INC.
1501 DECKER AVENUE #419
Ciiy
STUART
034994
Telephone Ext.
772-286-7694
Place
MA v i, i %1
VLs A `l'Is
surance agent/compa, and (3) building owner.
Copy all pages of th- ation Certificate and all attachments for (1) community official, (2) Inny
Comments (including type of equipment and location, per C2(e), if applicable)
C2-E A/C PLATFORM .
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 2 of 6
n
�— Building Photographs
See Instructions for Item A6.
. _ , . . ... For Insurance Company Use:
Bwlding Street Address QndUdjng Apt., Unr<, Suite, and/or 6idg. No) or P.O Route and Box No. Policy tvutnber
429 NETTLES BLVD.
City state ZIP Code camww WXNUMW
JFNSFN BFA,CH FLORIDA 34957
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least Wo building photographs below according to
the instructions for Item AG, Identify all photographs with: date taken; "1=ront Vies!' and "Rear View% and, if required, 'Right
Side vied' and "Left Sid* View." If, submitting. more photdoraphs than will :fit on this page, use the Continuation Page,
following. FRONT 12/12/2017 REAR 12/12/2017
SIDE 12/12/2017