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HomeMy WebLinkAboutElevation Certificate 1-22-16It U.S. DEPARTMENT OF HOMELAND SECURIT' LtVA I IUN C ER I If IC�A I' �; OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGEI, _ National Flood Insurance Program _ Expiration Date: Jul 31, 2015 Important: Read the instructions on pages 1-9. Y SECTION A -PROPERTY INFORMATION 1=UFt,1N5.URMCE_C,0WPA?+I C.USE Al. Building Owner's Name SULLIVAN 'Pd9cg N ?"b A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. C=pt y'1MC Number,=`=`; � ," f " 10725 SOUTH OCEAN DRIVE #327 ;',.', .• City JENSEN BEACH State FL ZIP Code 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 37, BLOCK B, HOLIDAY OUT A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27"16'11.2" N Long. 80*12'18.1" W Horizontal Datum: ❑ NAD 1927 N 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 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) N/A sq ft a) Square footage of attached garage 366 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 3 . c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 600 sq in d) Engineered flood openings? ❑ Yes N 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 I FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111 C 0314 J 02/16/2012 Effective/Revised Date Zone(s) AO, use base flood depth) 02/16/2012 AE 8.0 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: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 © NAVD 1988 ❑ Other/Source; _ B12. Is the building located in a Coastal Barrier Resources System �BRS) area or Otherwise Protected Area (OPA)? El Yes 0 No Designation Date: _ CBRS ❑ CPA 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. 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 A02 RM1 FLDT Vertical Datum: NAVD 88 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) 8.0 0 feet ❑ meters b) Top of the next higher floor _ 17.4 © feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A., ❑ feet ❑ meters d) Attached garage (top of slab) 3.41 0 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 8.0 0 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 3.1 ❑X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.2 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support QUA._ ❑ feet ❑ meters 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. © Check here if comments are provided on back of form.. Were latitude and longitude in Section A provided by a Check here if attachments. licensed land surveyor? Z Yes ❑ No Certifier's Name EARLE R. STARKEY License Number 004459 Title PROFESSIONAL LAND SURVEYOR Company Name ACCURIGHT LAND SURVEYING INC. Address 1501 DECKER AVENUE#4-t9"-L *)STUART State FL ZIP Code 34994 JOB# 1320-E3-FINAL PLACE SEAL OWZT/-2016 PLS #4459 nature �RLE Date 01/22/2016 Telephone 772-286-7694 FEMA F - -33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the r(��: ;ling information from Section A. _ FOR INSURANCE COMPkM' USE Building Street Address (including Apt., Unit, Suite, and ul`odg. No.) or P.O. Route and Box No. Policy Number:• 10725 SOUTH OCEAN DRIVE #327 City JENSEN BEACH State FL ZIP Code 34957 Companj NAIL Number: 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 Q2-X_A1e P' "4FQRI I Signature Date 01/22/2016 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 Sections 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 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or LJ below the HAG. E3. Attached garage (top of slab) is _ _ Elfeet ❑ 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 FEMA4ssued 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 Owners or Owners Authorized Representative's Name Address City State ZIP Code Signature Date. Telephone Comments SECTION G — COMMUNITY INFORMATION (OPTIONAL) Check here if attachments. 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—GI0. 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 bylaw 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: _ _ ❑ f9et ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: _ _ 0 feet ❑ meters Datum _ G10. Community's design flood elevation: _ _ ❑ feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature` Date Comments; _ ❑ Check here if attachments. _ r _ auilding Photographs See Instructions for Item AS. For insurance Company Suite. and/or Blda. No.) or P.Q. Route and Box No. I QcMCy Number 10725 SOUTH OCEAN DRIVE #327 State FLORIDA If using the Elevation Certificate to obtain NFiP flood insurance, affix at least two building photographsbelow according to the instnlc Lions for Item A6. Identify all photographs with: date taken; °Front View" and Tear View"; and, if required, "Right side. vies„ a and 'Left side View.' if submitting more photographs than will fit on this page, use the Continuation Page, following. FRONT 01/22/2016 REAR 01/22/2016 SIDE 01/22/2016