HomeMy WebLinkAboutELEVATION CERTIFICATE 12-7-18.,PARTMENT OF HOMELAND SE CITY,. ` I OMB No. 1660-0008
A' Fmerge0cy Management Agency V Expiration Date: November 30, 2018
ial Flood Insurance Program
ELEVATION CERTIFICATE
Important: Foll w the instructions on pages 1-9. sly
J Copy all pages of this Elevation Certificate and all attachment (1) community official, (2) insurance agent/ccPRL f"ri°d�NOil�Jmg owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Policy Number:
PARENT I
A2. Building Street Address'(including Apt.; Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
2044 NETTLES BLVD. I
City State ZIP Code
JENSEN BEACH FLORIDA 34957
A3. Property Description (Lot and Block Numbers, Tax Par el Number, Legal Description, etc.)
LOT 44, NETTLES ISLAND PROJECT SECTION 1 1
A4. Building Use (e.g., Residential, Non -Residential, Additio Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°17'09" Long. 80012'51" Horizontal Datum: ❑ NAD 1927 ® NAD 1983
least 2 the building if the Certificate is being used to obtain flood insurance.
A6. Attach at photographs of
AT 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 crawlspac 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 I sq in
d) Engineered-tloo,d'.openings? ❑ Yes ® No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
62. County Name
B3. State
UNINCORP 120285
ST. LUCIE
FLORIDA
B4. Map/Panel
B5. Suffix
B6. FIRM Index
67. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s)
Number
Date
Effective/
Zone(s)
(Zone AO, use Base Flood Depth)
Z. l I 1 G
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Revised Date
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑ FIS Profile ® FIRM ❑ Community Determined ❑ 10ther/Source:
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B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1'988 ❑ Other/Source:
B12. Is building located in Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
the a
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Designation Date: N/A ❑ CBRS ❑ OPA
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FEMA Form 086-0-33 (7/15) Replaces all revious editions. Form Page 1 of 6
ELEVATION CERTIFICATE,
OMB No. 1660-0008
Expiration Date: Novem
IMPORTANT: In these spaces, copy the 'Corr
Building Street Address (including Apt., Unit, S
2044 NETTLES BLVD.
City
JENSEN BEACH
finding information from Section A.
and%or Bldg. No.) or P.O. Route and Box No.
State ZIP Code
FLORIDA 34957
FOR INSURANCE C
Policy Number:
V/
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
I
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 FLDT ! Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevi ations in items a) through h) below.
❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
Datum used for building elevations must 6e the same as that used for the BFE
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a) Top of bottom floor (including basemelnt, crawlspace, or enclosure floor) _
b) Top of the next higher floor i _
Check the measurement used.
® feet ❑ meters
® feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters
d) Attached garage (top of slab) I N/A ❑ feet ❑ meters
7.0
16.4
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e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
8.57 ® feet
❑ meters
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f) Lowest adjacent (finished) grade next to building (LAG)
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4.10
® feet
❑ meters
Highest adjacent finished
g) g j (finished) next to building (HAG)
4.50 feet
®
❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
4.2 ® 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.
/ certify that the information on this Certificate represents my best efforts to interpret the data available. ! 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 prof ided by a licensed land surveyor? ® Yes ❑ No ❑ Check here if attachments.
Certifier's Name I License Number 1320-102-01
EARLE R. STARKEY 4459
Title
PROFESSIONAL LAND SURVEYOR _
Company Name _
ACCURIGHT LAND SURVEYING INC.
Address
1501 DECKER AVENUE #419 I
City State ZIP Code _
ST FLORIDA 34994 PLS #4459
Si nature Date Telephone Ext.
12/03/2018 772-286-7694
Copy all pag Is 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
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FEMA Form 086-0-33 (7/15) I Replaces all previous editions. Form Page 2 of 6
See
2044 NETTLES BLVD,
If using the Elevation Certificate to obtain NFIP flood
the instructions for Item A6. Iden* ail photographs.w
side View" and "Left Side View." If submitting more
following. FRONT 12/03/2018
for
i FL❑RIDA 34957
nsurance, affix at'least two building photographs below according to
the date taken; "Front McWO and "Rear View"; and jf required, "Right
photographs than will fit on this page, use the Continuation Page,
REAR 12/03/2018
SIDE 12/03/2018