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Home My WebLink AboutElevation Certificate'U.S. DEPARTMENT OF HOMELAND SCc: 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. RICHARD & SHERRY ANDERSON A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number. Box No. 10-120- SOUTH OCEAN DRIVE, • 482. City State ZIP Code JENSEN BEACH Florida 0 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 28, BLOCK M, HOLIDAY OUT IN AMERICA AT ST. LUCIE, INC., SECTION B A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°16'17' Long. 80°1221" Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2'phot6graphs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 8 0 A8. For a building with a crawlspace or enclosure(s): a) Square footage of'crawlspace or enclosures) 835 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 6 c) Total net area of flood openings' in A8.b 1200 sq in d) Engineered flood openings? ❑x Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage 327 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 2 c) Total net area of flood openings in A9.b 400 sq in d) Engineered flood openings? ❑x Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name State UNINCORP / 120285 ST. LUCIE rida rF B4. Map/Panel B5: Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevations) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12111 C 0314 J 02/16/2012. 02/16/2012 AE 7.0 & 8.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ 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 ELEVATION CERTIFICATLI,= OMB No. 1660-008 ' Expiration Date: November30, 2016 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. 1 Al ZS SOUTH Oc c- c," t2�JK Mo. 4134 City State ZIP Code, Company NAIC Number 1Z ON 5 a rV � cz A t 14 I FZ_ - 0 3 it cl S 7 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 w den construction of the building is complete. C2. Elevations —Zones Al—A30, AE, AH, A (with OFE), 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 A7. In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A02 RM2 FDOT 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 ❑ ther/Source: Datum used for building elevations must be th same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, c w[space, or enclosure floor) 4.13 ❑x feet ❑ meters b) Top of the next higher floor 8A ❑x feet ❑ meters c) Bottom of the lowest horizontal structural ember (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 3.8 x❑ feet ❑ meters e) Lowest elevation of machinery or equipm nt servicing the building ❑ feet (Describe type of equipment.and location tgComments) 1 ❑ meters 0Lowest adjacent (finished) grade next to bComments) (LAG) 35 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to i uilding (HAG) 3.7 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevatio of deck or stairs, including structural support 1 4.0 ❑x feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a Ipnd surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate repfesents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine or imprison ent under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provide�by a licensed land surveyor? 0 Yes ❑ No 0 Check here if attachments. I Certifier's Name License Number 1 d 3 * 23 Z! -`p _ o l t= EARLE R. STARKEY 004459 Title PROFESSIONAL LAND SURVEYOR I Place Company Name ACCURIGHT LAND SURVEYING, INC. Address 1501 S.E. DECKER AVENUE, UNIT NO.419D b 19 l Zr, 16 City State ZIP Code I Florida 0 34994 -PL5 # 00 4 ` S") ' nature � e 'Telephone Ext. �606/19/201 8 (772) 286-7694 N/A i 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 to lion, per C2(e), if applicable) C2(e) BOTTOM OF ELECTRIC PANEL I A8(b) & A9(b) FLOOD VENT MODEL NO. 1540-520 (200 SQUARE INCHES FOR EACH) FEMA Form 086-0-33 (7/15) 1 Replaces all previous editions. Form Page 2 of 6 Building Photographs See Instnkilons for Item A6. For lasurance Company Use: Building Street AWess (incWing Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Poficy Number 10725 SOUTH OCEAN DRIVE #482 city state ZIP Code canpWW UNC Nun JENSEN BEACH FLORIDA 34957 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographsbelow according to the instructions for ItemA6. Identifyall photographs with: date taken; "Front View" and "Rear VeW% and, if required, °Right Side Views' and "Left Side Mew.' tf submitting more photographs than will fit on this page, use the Continudtion Page, j L '� -. f �p`�t y� � ��- ��`��'ny'�"},� `^ ip�r� i rl f"�� N� �'�,5/ ✓,�V h .i 3{ zs�? 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