HomeMy WebLinkAboutELEVATION CERTIFICATE 6-20-18U.S. DEPARTMENT OF HOMELAND S' ~'RITY y 20
� , OMB No. 1660-0008
Federal Emergency Management Agenc-i---- Expiration Date: November 30, 2018
National Flood Insurance Program
KAMM ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pag� �f"tFir��levvatlonl ertificate 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.
MR. & MRS. GRUBER
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
10725 SOUTH OCEAN DRIVE #490
City State ZIP Code
JENSEN BEACH FLORIDA 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 18, BLOCK M, HOLIDAY OUT
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°16'19.5" Long. 80°12'21.7" 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.
A7. Building Diagram Number 1 B
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 416 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 NameA.Community Number
B2. County Name
B3. State
UNINCORP 120285 ::
ST. LUCIE
FLORIDA
B4. Map/Panel
85. 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)
{ Z L V C_
J
O Z, l(o.� 1Z.
Revised Date -
QZ` 1(o I t<Z
_
A
LA
�, a
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 139: ❑ NGVD 1929 PC NAVD 1988 • ❑ Other/Source:
B12. Is the building located in a 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 k}
OMB No. 1660-0008
t 1 Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding
information from Section A. d
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, a
d/or Bldg. No.) or P.O. Route and Box No.
Policy Number.
10725 SOUTH OCEAN DRIVE #490
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, ARIA, 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 A04 RM2 FDOT
Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevation
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, cra
Nispace, or enclosure floor) 9.0 ® feet ❑ meters
b) Top of the next higher floor
N/A ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural me=uilding
only) N/A ❑ feet ❑ meters
d) Attached garage (top of slab)
3.55 ® feet ❑ meters
e) Lowest elevation of machinery or equipment
(Describe type of equipment and location in
N/A meters
Comments) ❑ feet ❑
f) Lowest adjacent (finished) grade next to building
3.3
(LAG) ® feet ❑ meters
g) Highest adjacent (finished) grade next to building
(HAG) 3.5 ® feet ❑ meters
h) Lowest adjacent grade at lowest elevation of
structural support
deck or stairs, including N/A ❑ 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.
Were latitude and longitude in Section A provided by
la licensed land surveyor? ® Yes ❑ No ❑ Check here if attachments.
Certifier's Name
License Number
2703-01-01 UC
EARLE R. STARKEY
004459
Title
PROFESSIONAL LAND SURVEYOR
Company Name
ACCURIGHT LAND SURVEYING
INC.
`
Address
1501 ,DECKER AVENUE #419
05%30%2018
City
STUART
i late ZIP Code
FLORIDA 34994
PLS #4459
Signs
Date Telephone. Ext.
05/30/2018 772-286-7694
Copy all pages evation 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) '
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6