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Home My WebLink AboutELEVATION CERTIFICATE 12-17-18U.S. 15EPARTMENT OF HOMELAND SEC40 BY J1WFNo. 1660-0008 Federal Emergency Management Agency St'Lucle County Expiration Date: November 3D, 2018 Naflonal Flood Insurance Program ELEV . ATION CERTIFICATE Important: Follow the Instructions on pages 1-9. Copy all pages of this Elevation Cert1ficate and all attachments ifbr (1) community official, (2) Insurance agenilcompany, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owners Name Policy Number: THIEL A2, Building Street Address (including Apt., Unit, S61te, and/or Bldg. No.) or P.O. Route and Company NAIC Number, Box No. 10725'SOUTH OCEAN DRIVE #103 city JENSEN BEACH State FLORIDA ZIP Code 34957 A3, Property Description (Lot and Block Numbers, Tax Parcel Num6er, Legal Description, etc.) i LOT 1, BLOCK K, HOLIDAY OUT IN AMERICA AT ST. LUCIE A4. Building Use (e.g., Residential, Non-Residential,i I Addition, Accessory, etc.) RESIDENTIAL AS. Latitude/Longitude; Lat. 2701611" Long. 80* 1224!' 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 anclosure(s): a) Square footage of crawlspace or enclosure(s)� N/A sq It I b) Number of permanent flood openings In the "wispace or enclosure(s) within 1.0 foot above adjacent grade NIA Total net area of flood openings in A8.b NIA sq in c) d) Engineered flood openings? []'Yes M �o A9. For a building with an attached garage; a) Square footage of attached garage 531 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 3 o) Total net area of flood openings in A9.b 6001 sq in d) Engineered flood openings? Pfl Yes n No SECTION B — FLOOD 114PURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number B2. County Name B3. State UNINCORP 120285 ST. LUCIE FLORIDA B4. Map/Panel B5. Suffix lB6. FIRM Index B,7. FIRM Panel B8..Flood B9. Base Flood Elevation1s). Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) z I % i e, J Revised Date '7. BI 0. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89: FIS Profile R] FIRM [D Community Determined [] Other/Source: Bl 1. Indicate elevation datum used for BFE in Item Bg: NGVD 1929 [K] NAVD 1988 E] Other/Source: 812. ls the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No Designation Date: N/A CBRS E] OPA FEMA Form 086-0-33 (7/16) Replaces all previous editions. Form Pagel of6 ELE�ATIONICERTIFJCATE #011660-0008 tion 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 10725 SOUTH OCEAN DRIVE 0103 City State ZIP Code JENSEN BEACH Company NAIC Number FLORIDA 34957 SECTION C - BUILDINd ELEVATION INFORMATION (SURVEY REQUIRED) I C1. Building elevations are based on: Construction Drawings* [] Building Under Construction* M Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones AII-A30, AE, AH, A (with B'FE), VE, V1-V30, V (with BFE), AR, AR/A, ARIAE, ARIAII-A30, AR/AH, AR/AO. Complete Items C2.a-h belowaccording to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A02 RM2 FDOi Vertical Datum: 1988 -NAVD Indicate elevation datum used 1br the elevations in items a) through h) below. [] NGVD 1929 Z] NAVD 1988 n Other/Source: Datum used for building elevations must be the iame as that used for the BFE. I Check the measurement used. a) Top of bottom floor (including basement, cr"Ispace, or enclosure floor) 8.02 ZI feet E] meters b) Top of the next higher floor 17.4 rl feet meters c) Bottom of the lowest horizontal strudtural member (V Zones only) N/A f-1 feet meters d) Attached garage (top of slab) 4.38 feet meters e) Lowest elevation of machinery or equipment iervicing the building (Describe type of equipment and location in Comments) 8.2 feet meters Lowest adjacent (finished) grade next to buildi I I ng (LAG) 4.2--- feet meters g) Highest adjacent (finished) grade next to building (HAG) 4.6 feet meters I h) Lowest adjacent grade at lowest elevation of d eck or stairs, Including structural support 1 4.3 feet meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land s6rveyor, engineer, or architect authorized by law to certify elevation information. I cerfffy that the information on this Cerfificate represents my best efforts to inteipret the date 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 provided by a I I I icensed land surveyor? MYes E]No Check here if attachments. Certifier's Name License Number 1320-107-01 EARLE R. STARKEY 4459 Title PROFESSIONAL LAND SURVEYOR Company Name ACCURIGHT LAND SURVEYING INC. Address 1501 DECKER AVENUE #419 12/13/2018 city STUART state ZIP Code FLORIDA 34994 PLS #4459 Signatu Date Telephone Ext. 12/1312018 772-286-7694 Copy all pages of this Elevation Certificate and all attachmefiB'b&0��mmunfty official, (2) insurance agentleompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), W applicable) A9-D FLOOD VENT MODEL #1540-520 (SEE ATTAC�ED) C2-E A(C PLATFORM FEWA runn 056-0-3.3 krtio) Replaces all previous editions. Form Page 2 of 6 ELVATION "CERTIFICATE "o. 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: city state ZIP Code Company NAIC Number 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 El-E5. If the Ceitificate Is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items EI-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 F-1 feet [:1 meters rl above or below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is El feet 0 meters [3 above or below the LAG. E2. For Building Diagrams 6-9 With permanent flood bpenings 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 [I meters [-I above or F1 below the HAG. E3. Attached garage (top of slab) is 0 feet F-1 meters El above or [3 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is F] feet rl meters E] 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 owners 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, 8, and E are correct to the best of my knowledge. Property Owner or Ownees Authorized Representative's. Name Address city State ZIP Code Signature Date Telephone Comments Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEvAmNICERTIFICATE "o. 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 city State ZIP Code Company NAIC Number SECTION Q — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordlnan�e to administer the community's floodplain management ordinance can complete Sections A, 8, C (or 15), and G of this Elevation Certificate. Complete the applicable Rem(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. I G1. El 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. El A community official completed Section E for a building located in Zone A (without a FEIVIA-issued or community -issued BFE) or Zone AO. G3. [] The following information (items G4—G1 0) ii provided for community floodplain management purposes. G4. Permit Number G6. bate Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This has been issued for: New Construction Substantial Improvement permit I G8. Elevation of as -built lowest floor (including basement) of the building: I [I feet El meters Datum G9. BFE or (in Zone AQ) depth of flooding at the building site: F1 feet F1 meters Datum G10. Community's design flood elevation: feet meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, pe� 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, ccioy the corresp6nding Infolrmation from Secffon A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Sulte,!andfor Bldg. No.) or P.O. Route and Box No. Policy Number 10725 SOUTH OCEAN DRIVE' #103 city JENSEN BEACH StaleF L 0 R I D A ZIP Code Company NAIC Number 34957 If using 'the Elevation Certificate to obtain NFIP Illood 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 Mew." 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, J127 Photo One Caption FRONT 12/13/20 �18 Photo Ono lift . . . . . . . . . . . . . . . . . Ph.TWo Photo Two Caption REAR —12/13/2018. FEMA Form 086-0-33 (7/16) Replaces all previous editions. Form Page 5—of6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION C.E.RTIFICATE � Continuation Page Expiration Date:.Novernber 30,2018 IMPO&ANT" ln�-'tfie'4' dipa. ck , vo'ly' the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt.j Unit, Sufte'l andtor Bldg. No.) or P.O. Route and Box No. Policy Number 10725 SOUTH OCEAN DRIVE #103 city State ZIP Code JENSEN BEACH FLORIDA 34957 Company NAIC Number If submitting More photographs than YAII fit on the preceding page, affix the addillopal photographs below. Identify all photographs with: date taken; "Front VlevP a i nd "Rear �rfe�P; and, if'required, "Right. Side View"- and "Left Side View." When applicable, photographs must show the foundation with repros'entative examples of the flood openings or vents, as indicated in Section A8. . 40 ;Rom Moto T�100 Photo Three Caption RIGHT SIDE 12/1342018 744, P"" F*"' Ph oto Four CaptlonLEFI SIDE -12/13/2018 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6