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Home My WebLink AboutELEVATION CERTIFICATE 10-15-18L`L U.S. DEPARTMENT OF HOMELAND ��____ -IRITY OMB No. 1660-0008 Federal Emergency Management Agency 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: Perry H. & Karen M. Belanger A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 64 Aqua Ra Drive - Porch addition City State ZIP Code Jensen Beach Florida 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 11 less the East One -Half of Block A WINDMILL VILLAGE BY THE SEA UNIT TWO PB 16 PG 31 SLC Public Records A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat.27.265494 Long.80.206134 Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at lea st2photographs_of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 B A8. For a building with a crawispace or enclosure(s): a) Square footage of crawispace 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 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b 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 Unincorporated Areas - 120285 St. Lucie Florida B4. Map/Panel B5. Suffix 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) 12111 C0314 J 02/16/2012 02/16/2012 AE 6 1310. 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 0 NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 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: 64 Aqua Ra Drive - Porch addition 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" ❑x 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: Florida DOT BM 94-07-C-01* Vertical Datum: NAVD88 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) 6.60 ❑x feet ❑ meters b) Top of the next higher floor 7. 10 ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) ❑X feet Q meters d) Attached garage (top of slab) ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 6. 3 ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 6.0 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 6 1 ❑X feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 6.4 0 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. l understand that 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 a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number / James A. Cesiro Jr. PSM5543 Title President ; Digit Ily signed by Q Jame A. Cesiro Jr. e� aC" pN: . =James A. Company Name Atlantic Land Designs of the Treasure Coast, Inc. Tre `may=Iro Jr., o=Atlantic Land Design, CJ ou, rreemail ALD5543@gmai :com, b=us J Address PO Box 1421 r. Date: 2018.11.02 07:54:29-04'00' City State ZIP Code Jensen Beach Florida 34958 Signature I �gasllysigned byJames0.CesiroJr. Date Telephone A. Cesiro Jr., o=Aai'.. Land '.�,y�ms+) O .1-,' Ee: Vu"—'f}+ o�5i9n,ea,e Ail .sue u510/15/2018 n'James _ gman.eem,e (772) 398-4290 Dale: 2018.11.02 07:-.. -04'00' Copy a lIZages o this Elevatit n Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Commentsonc4&ng type o qui • ent and location, per C2(e), if applicable) C2e - HVAC (existing) C2 b. - FFE of porch addition Revision 10/05/2018 - Final inspection, updated photos Revision 10/15/2018 "Refer to DOT BM Martin County'BM N.C.L.H.I. was tied to. / New Pictures / HVAC Existing. Revision 11/2/18 - add new 'picture of back of house FEMA Form 086-0-33 (7/15) 1 Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTI ICATE 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: 64 Aqua Ra Drive - Porch addition —Ly State ZIP Code Company NAIC Number Jensen Beach Florida 34957 SEd, TION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items El—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( ncluding basement, crawlspace, or enclosure) is feet ❑ ❑ below the HAG. � ❑ meters above or b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters E] 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 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of lab) is ❑ feet. ❑ 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 floo depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management �rdinance? ❑ 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 FEMA-issued 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 Owner or Owner's Authorized Representative's Name Address Signature Comments City Date State Telephone Code ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 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: 64 Aqua Ra Drive - Porch addition City State ZIP Code Company NAIC Number Jensen Beach Florida 34957 SECTION G — COMMUNITY INFORMATION (OPTIONAL) 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 I 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. 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 by law to certify elevation information. (Indicate the source and date of the elevation data in the Commel nts 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: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design fli od elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15)' Replaces all previous editions. Form Page 4 of 6 > ' BUILDING PHOTOGRAPHS OMB No.1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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: 64 Aqua Ra Drive - Porch addition City State ZIP Code Company NAIC Number Jensen Beach Florida 34957 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs 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 vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. e - - Photo One Photo One Caption FrontVi�w - Photo taken 10/15/2018 -awf tl Photo Two Photo Two Caption Rear View - Photo taken 10/31 /2018 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE Continuation Page .I 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 (incidding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 64 Aqua Ra Drive - Porch addition City State ZIP Code Company NAIC Number Jensen Beach Florida 34957 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs 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 vents, as indicated in Section A8. IM! J ng Pn # 1{{ rx �' A I R�r}Ia.� •j � ^L Photo One Photo One Caption C2e ViewF - Photo taken 10/15/2018 Photo Two Photo Two Photo Two Caption FEMA Form 086-0-33 (7/15) I Replaces all previous editions. Form Page 6 of 6