Loading...
HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DEPARTMENT OF HOMELAND 5 �­,JRITY Federal Emergency Management Agency (� National Flood Insurance Program at Lucie C-Owty ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 (:nnv all paces of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. v SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: GWENDOLYN LANDERS I A2. Building Street Address (including Apt., Unit, Suite,'and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. I 4570 S OCEAN DRIVE City State ZIP Code FORT PIERCE Florida 34949 I A3. Property Description (Lot and Block Numbers, Tax Number, Legal Description, etc.) Parcel PARCEL ID 2529-343-0003-010-2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. N 27 23 45.78 LoI g. W -80 15 47.16 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 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0.00 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 I 0.00 sq in d) Engineered flood openings? ❑ Yes ❑X No A9. For a building with an attached garage: a) Square footage of attached garage 0.00 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 I 0.00 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 I SAINT LUCIE COUNTY, UNINCORPORATED 120285 SAINT LUCIE Florida B4. Map/Panel B5. Suffix B6. FIRM Index Date B7. FIRM Panel Eff, ective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) Number Revised Date 12111 C 0194 J 02-16-2012 02-16ii2012 i AE 6 I B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ❑X FIRM ❑ Community Determined ❑ Other/Source: i B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑X NAVD 1988 ❑ Other/Source: Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑X Yes ❑ No B12. Is the building located in a Coastal Designation Date: 10-01-1983 ❑CBRS i❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. form rage i or 6 I 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: 4570 S OCEAN DRIVE City State ZIP Code Company NAIC Number FORT PIERCE Florida 34949 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construct�l n Drawings* Z Building Under Construction" ❑ Finished Construction *A of the building is complete. new Elevation Certificate will be required when construction Zones Al A30, AE, AH, A (with BFE)l VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO. C2. Elevations — Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: SAINT LUCIE CO BM "B-308'1 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in Jtems a) through h) below. ❑ NGVD 1929 X❑ NAVD 1988 ❑ Other/ource: 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) 9.5 ❑X feet ❑ meters b) Top of the next higher floor I N/A Z feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A 0 feet ❑ meters d) Attached garage (top of slab) 8.0 X❑ feet ❑ meters e) Lowest elevation of machinery or equipment se icing the building N/A ©feet ❑meters (Describe type of equipment and location in Cc ments) 0 Lowest adjacent (finished) grade next to buildin� (LAG) 3.2 0 feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5.5 feet ❑meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A 0 feet ❑ meters structural support SECTION D — SURVEYOR,I ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, l that the information on this Certificate represents engineer, or architect authorized by law to certify elevation information. my best efforts to interpret the data available. ! understand that any false certify statement may be punishable by fine or imprisonment unlder 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. I Certifier's Name License Number CHARLES ARNOLD, PSM FLORIDA LS #4971 Title VICE PRESIDENT _ \ ` lac @ Company Name ARNOLD SURVEYING, INC.f Address 4888 N KINGS HIGHWAY #425 City State ZIP Code FORT PIERCE I Florida 34951 `\ Signature Date Telephone Ext. 09-16-2018 (772) 708-1819 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) A5 OBTAINED USING HANDHELD DEVICE; B9 LOT HAS SEVERAL ZONES BUT HOUSE LIES SOLELY IN ZONE AE-6; C2 EC IS FOR FORMBOARDS ONLY; C2A REFERS TO FLEX SPACE SEPARATED BY WALL FROM GARAGE MEANING GARAGE IS ATTACHED; C2D REFERS TO GARAGE SEPARATED BY WALL FROM FLEX SPACE MEANING GARAGE IS ATTACHED; PGS 1, 2 & 5 COMPLETED BY SURVEYOR; PGS 3,4 & 6 LEFT BLANK INTENTIONALLY & IS NOT CERTIFIED BY SURVEYOR FEMA Form 086-0-33 (7/15) Replalces all previous editions. r""" 'ELEVATION CERTIFICATE l 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/ it Bldg. No.) or P.O. Route and Box No. Policy Number: 4570 S OCEAN DRIVE City State ZIP Code Company NAIC Number FORT PIERCE Fldrida 34949 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 Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use nat �l ral 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 adj�cent 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. For Building Diagrams 6-9 with flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), E2. permanent 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 I ❑ 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 OWNERI(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 st i tements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address I City State ZIP Code Signature I Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form rage S or 0 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: 4570 S OCEAN DRIVE City State ZIP Code Company NAIC Number FORT PIERCE Florida 34949 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 certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) i ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) G2 or Zone AO. G3. ❑ The following information (Items G4—G10) is pr Ivided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued has been issued for: ❑ New Con Itruction ❑ Substantial Improvement G7. This permit G8. Elevation of as -built lowest floor (including basementI ❑ feet ❑ meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: E] feet E] meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name I Title 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 (7/15) Replace'Is all previous editions. r-orm rage 4 oT b BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. 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/oar Bldg. No.) or P.O. Route and Box No. Policy Number: 4570 S OCEAN DRIVE City State ZIP Code Company NAIC Number FORT PIERCE Florlida 34949 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. Photo One Photo One Caption FRONT VIEW -PHOTO TAKEN SEPTEMBER 15, 2018 Clear Photo -One I THISSECTION LEFT BLANK I I I I Photo Two Photo Two Caption I Cleat Photo Two FEMA Form 086-0-33 (7/15) Replaces all pre i ious editions. r-orm rage o or o ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page 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/pr Bldg. No.) or P.O. Route and Box No. Policy Number: 4570 S OCEAN DRIVE City State ZIP Code Company NAIC Number FORT PIERCE Florida 34949 If submitting more photographs than will fit on the prel eding 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 IS SECTION. LEFT BLANK Photo Three Photo Three Caption I Clear Photo Three THIS tEcnoN LEFT BLANK I Photo Four Photo Four Caption I ;Clear Ptoto Four FEMA Form 086-0-33 (7/15) Replace i all previous editions. t-orm rage b or b