HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DEPARTMENT OF HOMELANLv_1 :.:CITY CANNED OMB No.1660-0008
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Federal Emergency Management Agency �� Expiration Date: November 30, 20113 Flood Insurance Program
ELE
VATION"- ICATE
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:
Herbert & Kathleen Yancy
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
581 Beach Ave.
City State ZIP Code
Port St. Lucie Florida 34952
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Parcel ID: 3419-510-0231-000-9
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 27° 20' 02.5" Long.080' 20' 03.0" Horizontal Datum: ❑ NAD 1927 Z 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 1A
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in
d) Engineered flood openings? ❑ Yes ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garage 627 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A9.b 0 sq in
d) EngieererfAgpd openings? ❑ Yes Z No
1� 4
-;,SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1: NFIF Corntnunity Name;. Community Number
B2. County Name
B3. State
St. Lucie County 120285
Saint Lucie
Florida
B4. Map/Panel",.
135: Suffz"
B6. FIRM Index
B7. FIRM Panel
B8. Flood Zone(s)
B9. Base Flood Elevation(s)
Number
Date
Effective/
(Zone AO, use Base
Revised Date
Flood Depth)
0280
J
02/12/2012
X, AE-6
X=N/A, AE-6=6
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
❑ FIS Profile Z FIRM ❑ Community Determined ❑ Other/Source:
B11. 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 M No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
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:
581 Beach Ave.
City StE ite ZIP Code
Company NAIC Number
I
Port St. Lucie Florida 34952
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction
Drawings* N 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)I
VE, V1 V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 A30, AR/AH, AR/AO.
Complete Items C2,a—h below according to the bui
ding diagram specified in Item AT In Puerto Rico only, enter meters.
Benchmark Utilized: SLNF BM2
Vertical Datum: NAVD 1988 (elevation of 6.29 feet
Indicate elevation datum used for the elevations in
i
Items a) through h) below.
❑ NGVD 1929. Z NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the sa
a as that used for the BFE.
Check the measurement used.
a) Top of bottom floor (including basement, crawispace,
or enclosure floor) 10 0 ® feet ❑ meters
b) Top of the next higher floor
X❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member
(V Zones only) ❑x feet ❑ meters
d) Attached garage (top of slab)
I 9.7 x❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing
the building 10 0 RI feet ❑ meters
(Describe type of equipment and location in Co
ments)
f) Lowest adjacent (finished) grade next to building
(LAG) 9 5 x❑ feet ❑ meters
g) Highest adjacent (finished) grade next to buildi
i g (HAG) 9.7 x❑ feet ❑ meters
h) Lowest adjacent grade at lowest elevation of dick
or stairs, including 9 5 0feet E] 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 n:preser is my best efforts to interpret the data available. I understand t
at any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by al licensed land surveyor? 0 Yes ❑ No ❑ Check her
if attachments.
Certifier's Name
License Number
r.
Herbert E. Yancy
LS4274
Title
l
Professional Surveyor & Mapper
A-r
f r _ `Place:
�'. c
Company Name
Herbert E. Yancy, PSM
Y
�° , y ' Seal,
as;
,, Here =� _
Address
4217 Sunrise Blvd
City I State ZIP Code
Fort Pierce Florida 34982
f. -
Signature Date Telephone
04/19/2019 (772) 519-6398
Copy all pa es of this Elevation rert' icate and Iattachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of e4Wment and lbbation, per C2(e), if applicable)
i
l
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page Z of Ei