HomeMy WebLinkAboutELEVATION CERTIFICATEi
,U.S. DEPARTMENT OF HOMELAND SEGI` ' `'FY ��N�� vi0 B No. 1660-0008
Fedel al Emergency Management Agency �� -�� Expiration Date: November 30, 2022
National Flood Insurance Program
ELEVATI614udfliftORTFICATE
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:
GREGORY & JODI PETERS
A2. Building Street Address (including Apt., Unit, Suite,land/or Bldg. No.) or P.O. Route and Company NAIC Number:
Box No.
8036 S. OCEAN DR. !
City ! State ZIP Code
JENSEN BEACH Florida 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 20, DIAMOND SANDS PLAT NO.2 (PLAT BOOK 54, PAGE 40); PARCEL ID:3527-501-0021-000-8
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.27.31689N
A6. Attach at least 2 photographs of the building if the
A7. Building Diagram Number 7
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s)
b) Number of permanent flood openings in the
c) Total net area of flood openings in A8.b
d) Engineered flood openings? ❑ Yes 0
A9. For a building with an attached garage:
a) Square footage of attached garage
b) Number of permanent flood openings in the
80.22506W
Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983
cate is being used to obtain flood insurance.
1450.00 sq ft
or enclosure(s) within 1.0 foot above adjacent grade N/A
N/A sq in
1008.00 sq ft
garage within 1.0 foot above adjacent grade 6
c) Total net area of flood openings in A9.b j 1200.00 sq in
d) Engineered flood openings? ❑R Yes ❑ N
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number I B2. County Name B3. State
S. LUCIE COUNTY INCORPORATED AREAS, 120285 ST. LUCIE COUNTY Florida
B4. Map/Panel B5. Suffix B6. FIRM Index
Number I I Date
12111 C0303 I J 1 02-16-2012
B7. FIRM Panel B8. Flood
Effective/ Zone(s)
Revised Date
02-16-2012 AE
B9. Base Flood Elevation(s)
(Zone AO, use Base Flood Depth)
7.0'
B10. Indicate the source of the Base Flood Elevation i(BFE) data or base flood depth entered in Item 139:
❑ FIS Profile ❑x FIRM ❑ Community Deteri ined ❑ 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)? ❑x Yes ❑ No
Designation Date: 10-10-1983 ❑x ! CBRS ❑' OPA
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6
1
ELEVATION CERTIFICATE
FMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
nd/o Bldg. No.) or P.O. Route and Box No.
Building Street Address (including Apt., Unit, Suite, and/or
Policy Number:
8036 S. OCEAN DR.
City State ZIP Code
Company NAIC Number
JENSEN BEACH Florida 34957
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ CbnstructiI n Drawings* ❑ Building Under Construction* 0 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: FDOT A1A 94-08-BM12 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) 8.4 0 feet ❑ meters
b) Top of the next higher floor I 19.5 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) 16.5 ❑x feet ❑ meters
d) Attached garage (top of slab) I 7.1 ❑x feet ❑ meters
e) Lowest elevation of machinery or equipment sgrvicing the building g,2 feet meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to build! n1g (LAG) 5.6 ❑x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 6.6 0 feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support I 6.8 ❑x 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. 1 understand that any false
statement maybe 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.
Certifier's Name License Number
MATTHEW CROWLEY PSM #7214
Title
PRESIDENT
Company Name
MERIDIAN LAND SURVEYORSdkldl
Address
1717 INDIAN RIVER BLVD SUITE 201'J""
City State ZIP Code
VERO BEACH Florida 32960
i
Signat
Date Telephone Ext.
Tz Zp (772) 794-1213
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)
PRIMARY BENCHMARKIS FLORIDA DOT MONUMENT A1A/94/08/BM12, ELEVATION = 3.51' NAVD '88.
ON SITE BENCHMARK IS FD PK NAIL & DISK LB#6905, 16.4' SOUTH OF THE SOUTH PROPERTY LINE ALONG THE EAST SIDE
OF THE ROAD, ELEVATION = 4.75' NAVD'88.
A/C PAD USED TO DETERMINE C2-E.
LATITUDE AND LONGITUDE DETERMINED USING HAND HELD GPS DEVICE.
I
FEMA Form 086-0-33 (12/19) iReplaces all previous editions. Form Page 2 of 6
ELEVATION CERTIFICATE
.DMB No. 1660-0008
Expiration Date: November 30, 2022
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:
8036 S. OCEAN DR.
City State ZIP Code
Company NAIC Number
JENSEN BEACH Flo ida 34957
SECTION E — BUILDING ELEV�TION 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 E1—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 (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 opel
ings 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 I
❑ 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 ❑ io
❑ 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
Signature Date Telephone
Comments
I
i
I
❑ Check here if attachments.
FEMA Form 086-0-33 (12/19) Re laces all previous editions. Form Page 3 of 6
ELEVATION CERTIFICATE
DMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding
information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/o
Bldg. No.) or P.O. Route and Box No.
Policy Number:
8036 S. OCEAN DR.
City State ZIP Code
Company NAIC Number
JENSEN BEACH Flo i ida 34957
SECTION G — COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance toff 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 metersl.
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.
G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes.
G4. Permit Number
G5. Daie
Permit Issued
G6. Date Certificate of
Compliance/Occupancy Issued
G7. This has been issued for: ❑ New Construction
❑ Substantial Improvement
permit
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 flood elevation:
❑ feet ❑ meters Datum
Local Official's Name
Title
1
I
Community Name I
Telephone
Signature
Date
Comments (including type of equipment and location, per
C2(e), if applicable)
❑ Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6
ELEVATION CERTIFICATE
!� BUI I DING PHOTOGRAPHS
See Instructions for Item A6.
OMB No. 1660-0008
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the corresponding, information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, andor Bldg. No.) or P.O. Route and Box No.
Policy Number:
8036 S. OCEAN DR.
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.
.y
f
i
"k
y711i
^
Photo One
Photo One Caption FRONT VIEW 3/10/20 I ,-
Clear Photo One.
,
..gi. !
!•k y i CIS: � {
l`r[
Photo Two
Photo Two Caption RIGHT FRONT VIEW 03/10/20 I
Clear Photo,Two
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6
ELEVATION CERTIFICATE
BUIIJDING PHOTOGRAPHS
Continuation Page
OMB No. 1660-0008
Expiration Date: November 30, 2022
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:
8036 S. OCEAN DR.
City
Sfate
ZIP Code
Company NAIC Number
JENSEN BEACH
Fliorida
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.
1
77
ii ;P��
l.xrly
`
M
l;
W
Photo Three
Photo Three Caption LEFT SIDE VIEW 03/10/20
Clear:Photo Three
G
fi V.-
Photo Four
Photo Four Caption LEFT REAR 3/10/20
r Clear'Fhoto
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6