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Home My WebLink AboutELEVATION CERTIFICATE 4-13-18• U.S. DEPARTMENT OF HOMELAND SECURITYSCANNE Federal Emergency Management Agency B National Flood Insurance Program St Lucie Cou ELEVATION CWRTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/companv. and (3) buildino owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: BRYAN SMITH A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company r. p y NAIC Number Box No. 5705 OLEANDER BLVD. City State ZIP Code FORT PIERCE Florida 34982 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 3409-114-0003-000-5 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL SINGLE FAMILY ADDITION A5. Latitude/Longitude: Lat. 27A111001 Long.-80.333902 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 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑ Yes ® No A9. For a building with an attached garage: a) Square footage of attached garage 0 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) Engineered flood openings? ❑ Yes ® No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State CITY OF FORT PIERCE 120286 SAINT 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) 12111CO187 J 02/16/2012 02/16/2012 W N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89: ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes [2 No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 6"fi b 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: 5705 OLEANDER AVE City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 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: CO BM 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. i Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 15. 5 ® feet ❑ meters b) Top of the next higher floor NIA. ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters d) Attached garage (top of slab) NIA. ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 14. 3- ® feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building 14. 0 ® feet ❑ meters I(LAG) g) Highest adjacent (finished) grade next to building (HAG) 14. 1 ® feet ❑ meters i h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑ 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 imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No ❑ Check here if attachments. Certfiers Name License Number - _ J MARK W. TEEPE 4811 _ Title P.S.M. Company Name CORNERSTONE SURVEYING - �� Address 325 SW SOUTH QUICK CIRCLE r City 'State ZIP Code PORT ST. LUCIE Florida 34953 Signature Date Telephone W 6 04/09/2018 7724182376 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) Air condt. unit This is the elevation information for the addition. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 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. 5705 OLEANDER BLVD. City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items Ei—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. 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 (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ 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 slab) 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 flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ 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 City State ZIP Code Florida Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7115) 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. 5705 OLEANDER BLVD. City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 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 G 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 Comments 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. I G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. I 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: E]feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet [] meters Datum Local Official's Name Title Community Name Telephone Signature Date I 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, 20 f8 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. 5705 OLEANDER BLVD. Policy Number. City State ZIP Code FORT PIERCE Florida 34982 Company NAIC Number 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 AS. If submitting more photographs than will fit on this page, use the Continuation Page. ....... MOD One Photo One Caption front view 04/11/18 i Photo Two Caption 04-11-18 FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No.lssa000s ' ELEVATION CERTIFICATE Continuation Page 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. 5705 OLEANDER BLVD. City State ZIP Code Company NAIC Number FORT PIERCE Florida 34982 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. t Photo One Caption Photo Two Photo Two Caption FEMA Form 086-0-33 (7/15) Replaces all previous editions. - Form Page 6 of 6 APR 13 2018 - Permitting Department 1 ---_w_-_—_---St,-Lucie-County;-FL-- I