HomeMy WebLinkAboutELEVATION CERTIFICATEU.$. D ' kRTMEN7 OF HOMELAND SECS'_ `�fY � '
Federal Emergency Management Agency OMB No. 1660-0008
9 Y 9 9 Y -` '�
' Expiration Date: November 30, 2018
National F1ood Insurance Program
ELEVATION CERTIFICATE
Important: Followthe 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.
BILLANE
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
2149 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH FLORIDA 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 149 NETLLES ISLAND PROJECT SECTION 1
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: L•at 27°17'13.1" Long. 80°12'48.5" Horizontal Datum. ❑ NAD 1927 ® 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 5
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 ® 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 ® 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
84. 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 Flood Depth)
0 13Z
J
Revised Date
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
B12. Is the building located ina Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® 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'
, OMB No. 1660-0008-. ` - ~__�W
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:
2149 NETTLES BLVD.
City
State ZIP Code
Company NAIC Number
JENSEN BEACH
FLORIDA 34957
SECTION C - BUILDING
ELEVATION INFORMATION (SURVEY REQUIRED)
C1. 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 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 ® 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) 8.6 ® 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 or equipment servicing the building 6.7 ® feet ❑ meters
(Describe type of equipment and location in Comments)
4.5
f) Lowest adjacent (finished) grade next to building (LAG) ® feet ❑ meters
g) Highest adjacent (finished) grade next to bullding (HAG) 5.0 ® feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4.4 ® 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 imprisonme I t under 18 U. S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? M Yes LINO ® Check here if attachments.
Certifier's Name
License Number
2627-01-01
EARLE R. STARKEY
004459
`
Title
PROFESSIONAL LAND SURVEYOR
Company Name
ACCURIGHT LAND SURVEYIf�G
II
INC.
Address
1501 DECKER AVENUE #419
01/03/2018
City
STU
State ZIP Code
� I
LORIDA 34994
PLS #4459
Signature I
Date Telephone- Ext.
03/2018 772-286-7694
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)
C2-E A/C PLATFORM
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
V
Building Photographs -
See Instructions for Item AS.
uite, and/or Bldg. No.) or P.O. Route and Sox N,
2149 NETTLES BLVD,
Number
City State zip Lone .�•,
JENSEN BEACH FLORIDA 34957
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear Vevf; and, if,required, "Right,
Side view' and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following. FRONT 01/03/2018 REAR 01/03/2018
SIDE 01/03/2018