HomeMy WebLinkAboutElevation Certificate 9-15-16`.SECTIONA-.PROPERTY"INFORMATION.. '• : ,'.
FOR INSURANCE COMPANY 08E
Al. Build ing.Own&s Name ..... 'Note. NofVolid to use for ang other,person 6r.6tiryJ.
Policy Number::
STANDARD PAC[ F.IC HOMES
A2.• BuildingStreet Address Includin A.t.• Unit :Suite; and/or,Bldg. No. or P:O'..Route and :.'
( g.. p ,
:Company NAIL Number; -
Box NO.
3050 NW RADCLIFFE WAY.
City ..:: " .. • :. .. '. State .. .. 'ZIP:Code;
PALM.CITYFL'. ' , .. 34990 .. _ ..
r
A3, 'Property Description (Lot and Block Numbers, Tax Parcel Number; Legal;Descrip'tion,:etc.) '
. ..
"RIVERBENW LOT 14 ..
A4. BuildingUse.(e:g.; Residential; Non-Residential,.Addition, Accessory, etc.) RESIDENTIAL "
A5:.Latitude/Longitudei.Lat._27"07'55.20'1 N Long:80'10:26.b4" W Horizontal Datum;❑ NAD 1927.,N MAD ,1983 .
A6.: Attachbt least 2 photographs of the building ifthe Certificate, is'being used to obtain flood, insurance: .
A7::Building Diagram Number:l_A . ."
A8. For• a building:With a crawlspace'of enclosure(s)c -,-
a) Square footage ,of.erawlspace or enclosures) N Asq. ft:
b) Number of, peemanentilood openings in the crawlspace'or:enclosure(s) Within 1:0 foot' above_adjacent grade'0.
c).Total'net area of flood openings'in A8.b'0 sq. in!,'
0)Engineered flood openings? •❑.'Yes:®. -No. ..
A9.- Fora building -With an attached garage:...
a) Square'footage of attached garage 1004 sq. ff..
b),Numbe'of permanent flood openings in the attached:garage within 1,0 foot above adjacent grade 0
c). Total net'area o' flood openings m_A9.b 0 sq. in. " .
_ ..
:'.d) EnSineered-fiood openings? .. ❑ Yes ®. No ....
:. SECTION;B='FLOQD INSURANCE RATE MAP (FIRM) INFORMATION
B7: NFIP`Cemmunit y-Ma7ne &=Community Number,
B2.. County Name
63.
State
:`;ST. LUCMCOUNTY 22Q205'.' . -
3T:,I UCIE COUNTY.
FLORIDA
"Map/Panel .:
BS. 'suffix
66:'Firm Index ..'87::
FIRM'Panel ..
B8. Flood Zones) :'
139; Base Flood Elevations) '
Numi�er
Date
Effective/
(Zone AO; use:Base .:
:. ::' ....
Revised.Date ::
.Flood Depth)-.: •.
101iG04061''
J
02/T6/2012::
02/16/2012.
-AEX
FEET(AE).
B10. Indicatetheisourceofthe Base Flood. Elevation.(BFE) data, or'base'.flood-depth entered.in item 99: ..
El FIS Profile . 0.. FIRM; ❑ Community Determiner. ❑ Other/Source;
B11. -Indicate Elevation Datum Used for BF.E in Item 69t ❑ NGVD.1929 ®NAVD A988 . ❑, Other/Source:
B12. Is the building located in a Coastal Barrier Resources-Systerrf(CBRS) area or otherwise Protected Area (OPA)? , ' 0 Yes ® No
Designation Date: MIA ❑. CBRS. ❑ .OPA
r
OMB N0:1666 008.
ELEVATION .CERTIFICATE t xpirition Date: November 30,1018
IMPORTANT; In these spaces,. copythe _correspondmg-informatlon from Section A.
'FOR, INSURAIVCE'CQMPANY USE. .:
'Building Street Address:(Including Apt., Unit, Suite, and/or Bldg.:No. or P.O. Route and Box'No...
Policy Number:,
3050 NW RADCLIFFE'WAY
:
City State Zip Code
Company NAIL Number::
PALM CITY' FL :.34990
SECTION C - BUILDING'ELEVATION INFORMATION (SURVEY. REQUIRED)
C1. Building Elevations:are Based on::'.' .� Construction Drawings' ®; Building UnderConstruction* O:.Finished Construction
._ _
*'A new EleVation-Ceitificate will. be required When'construction;of the building is complete.
C2; .Elevations =Zones A1:- A30, AE,_AH,-A (With BFE), VE V1= V3%-V (With BFE); AR, AR/A,, AR/AE, AR/Al -A30, AR%AW, AR/AQ. '
Complete .ltenis'C2:a - h below according to,the building diagram specified in•Itdm A7. In: Puerto. Rico only; enter.. meters.
-Benchmark Utilized: TIDAL BM ST: LUCIE COUNTY: 872 2334 TIDAL 4'; EL= 2.60 Vetiical Dati m.'NAVD •1988 '.. -.. .
Indicate elevation datum, used for the elevations in Items a) through h►. below: .
:.: -
0 NOD 1929 U NAVD•1988. [3Other%Source:
Datum used for building elevations must be the sarrie'as that used f6r the BFE. Check the measurement used: .
a) Top of Bottom Floor(including bdsement, crawlspacd .or enclosure -floor). 10.63 :feet . [] .meters'
b): Top of Next Higher Floor .. N.A 0 ' f e'et ❑ 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 or equipment servicing building
N.A.,feet :".Q.'meters
(Describe type:of equipment;and location'in Comments) .:
f) Lowest adjacent,(.finished);-grade next to building•(LAG) .: :: :. 7.4. _ -.19' feet • El meters
g)' H'ighestadjacent (finished) grade next to building (HAG) . 9.7 0, feet :.❑.•meters "..
_ :.h) Lowest, adjacent at lowest elevation of deck or,stairs. ;_including • .'
NA. 0 feet . -0' 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 authortied by lawto ceri'ify elevation information:
I certify: that the' information on this Certificate mpresents�my best efforts to interpret the. data dvaiLa'ble: l ynderstand that:any false ,
statement may be punishable byfine.'or imprisbnrridnt-under 18.V.5: `Code, -Section 1601.
Were latitude and longitude in Section.A provided by_a licensed land -surveyor?. ®Yes N . Check here if attachments..
-
Certifier's Name:' License Number:
Plac
David P. Lindley, PILS, L.'s. 5005
t�
�!f
Title: :
Professional Land Surveyor .
-R---
Company Name:
—
pavid P L<4 ntfie•Y, PO ._ .,
Caulfield.& Wheeler, Inc.::
L.S. 5005 5ta# c),.Florida
i 9.9/35/20'i6 -
Address:.:
..
7900 Glades Road .- Suite 100,
i r va4d +A fie.sianatuie:ane. '
Nc ithout .
the on_giaal raised seal of a Florida'-`
icefsed yurvepnr Fi A?upper
City: - Stafec :. Zip.Code:
Boca Raton - FL :. 33434
.._.;�.
Signature: Date: .. Telephone:::
09%15/2016 ..''. 561492-1991;
Copy all Pages of this Elevation Certificate and all attachments for. (1) community official :(2) insurance agent/company, arid (3)-building owner.
Comments (including type of equipment and loeation; per C2(e); If applicable:
Item AS) .Latitude & Longitude obtained by Magellen GPS,Blazer 12.:.,
This Certificate is notvalid unless. tea led with an embossed-surveryor's seal: ;
FEMA'Form 086-0-3317115)
►cepiaces au previous editions .. ras< 4 vU
ELEVATION CERTIFICATE : ' :: Expiration Date:.November30,'2018
IMPORTANT: In ihese'spaces; copy the.corre- ponding Information from Section A. FOR INSURANCE COMPANY USE.
Building Street Address :(Including'Apt.,'Unit-, Suite, and/or. Bldg.: No: or Pb_: Route and -Box No'... Polity NUinber:
•3050 NW RADCLIFFE"WAY ....
•
city " Stat'e Zip:Code, Company NAIC Number::
PALM CITY.. :FL - .34990 .. . '
SECTION.E BUILDING ELEVATION INFORMATIOW(SURVEY NOT REQUIRED]
FOR.ZONE A0, .AND ZONE -A ('WITHOUT (FE)
For.Zones AO and A (Without BFE);-complete Items El ES: If.the'Urtificate, is intended to support.a LOMA and.or:LOMR-F request,
complete Sections A;,B; and'C. For Items,E1-E4,. use-natural.grade,, if available:. Check tiie'measurement used.. In Puerto Rico only,
enter meters: .
E1. ,Provide elevation information for the following 6nd.c.heck,the appropriiate-boxes to show.whether the.efevation is above or below..
the highest adjacent,grade (HAG)' -and the lowest adjacent'.grade'(LAG):: .
'a) Top of bottom floor'(inclbding basement, N A e' or ;❑ :below the HAG.
crawlspace,.or.encl 'sure) is
❑'feet . ❑ meters; ❑ abo4
b):Top of bottonh floor. (including basement;' ... E
crawlspace, or enclosure) is-
N A: ❑feet .: meters ❑ above or ' Q belowahe: LAG
E2..-For Building Diagrams`.6-9 with permanent flood openings. provided. In Section A.Items 8 and/or'9 (seeepage's 1-2 of instructions);
the next higher"floor (elevation C2,ti in
the diagrarris) ofthe bwlding is- N. A. -� feet . meters , above or below' HAG
E3: Attached ;Garage.(to of slab " N A. ❑feet ' °meters above or below the HAG
.p ),. 1_ . �.. ❑ ..
E4. Top of platform.of m' achinery,and/or
equipment - - _ N A. feet ❑'.meters . ❑ ' above or. ❑. belovii the HAG
servicing the buildingis -
•E5..' Zone I
AO•.only; If no flood depth number-is:available, is the top of the floor elevafed in accordance with -the community's
floodplain management:ordinance?.. ❑Yes 0 No .Unknown. The local official must certify this information in Section.G.'
SECTION•F= PROPERTY- OWN ER- (OR OWNER'S REPRESENTATIVE) CERTIFICATION,
The property Owner.or.OWner's authorized representative who completes Sections A, B,'and E. for Zone'A (witho.Ut a' FEMAAssUed Or
commohity4ssuied BFE) Or. Zone AO mUst'sign here: The.statenients. in Sections A,'B,-and E-are correct to the best of my knowledge:
Property Owner: or Owner's°Authorized'Representative's'Namei
Address' : City .. State Zip Code.. :.
•Signature; , Date,',. Telephone.- :. T e:
Comments .' _.
. .: ❑ Check here if attachments: '
FEMA Form 086-0-33 (7/15) ' Replaces all: previous editions Page 3 of 6
OMB No:1660-008
ELEVATION CERTIFICATE Expiration Date; November 30, z018.
IMPORTANT: Inthese'spaces;copythe.correspondinglnformationfromSectionA;. FGR.INSURANCE COMPANY USE.
Building Street Address:(Including Apt., Unit Suite,=and/or.Bldg.:No; or P.O.' Route'andlox No... -Policy Number;
3050 NW RADCLIFFE WAX .
Clty Zip Code ' Company:NAIC Number:;
State
PALM CITY... FC _ : 3.4990:. .
SECTION G=COMMUNITY INFORMATION -,(OPTIONAL) -
Tlieiocal.officialwho isauthorized by;aaw or ordinance to administer the co:rrimunity's flgodplam management ordinance can.complete
:.
Sections A,.6, 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.
Gi.. []'. The Information in Section'C was.take'n,from other documentation.'that.has•been signed and sealed bya licerised: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);
52. M .A community official compl'eted.Section E for a building located in Zone A (without a FEMA issued -or community issued- BFE) .:
or Zone AO:.
G3.. E The follovring.information' (Items G4 — G1O) is provided for community floodpl'pin management purposes.
64. Permit Number: GS:.Date Permit Issued, I G6.: Date •Certificate of
Compliance/Occupancylssued
G7:. This Permit:has been issued :for: 0_ New Constfuction : Substantial Improvement
G8. Elevation of`as built`lowe.st floor (Intl uding,basement)
of the building:: ..
0
feet ' . D meters Datum
G9: BFE or (Zone AO) depth of flooding atthe building site: .feet : '� meters. Datum
G10: _Community's design flood elevation: �. feet.. ❑: meters Datum -
The property.oyiinero'r 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. Thestatements in Sections•A,•B, and E are correct to the best of my:knowledge; .
Local Official's. Name .. Title
Commpnity.Name Telephone
.Signature. Date.
= Comments.....
. � Check -here if'attach ments:
FEMA Form 086 0-33 (7/15) Replaces all previous.edltions. Page 4 of 6
IMPORTANT:1n.thesespaces, topV.ihe'corresponding information froni.Section A: ' .:
' FOR .INSURANCE ' COMPANY. USE ."
Bwlding Street Address (Including Apt:, Unrt, Suite; and/or: Bldg: No. or P:O.'Route and Box No:
Policy Number::
,. '
3056 NW RADCLIFFE WAY.-,.
te: .'
City... State:,.. Zip'Code
C ICNumber:.
ompany NA -
..
PALM CITY -FL 344 0::
'
If using the. Elevation Certificate. to.obtain:NFIP. flood Insurance,'.affix.at.
least: 2 building.photogtaphs below. according_ to -the.
instructions. 'for Item A6.. Identify'all OFhotographs.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'vehts, as indicated in Section A8. If submitting.. photographs.th6n
Will fit'on this age; use the Continuation Page.
,
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Photo One Caption: Front View:
Photo Three Caption:. Rear View
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4.
Photo:TWo.Caption! Left:View'
Photo Four'tap6o6: Right View