HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DEPARTMENTOF HOMELAND SECURITY,ELEVATION CERTIFICATE`. �g�pOMB No. 1660-0008
Federal Emergency Management Agency �� 4CANK Expires March 31, 2012
National Flood Insurance Program Important: Read the instructions on pages 1-9. pl�
SECTION A - PROPERTY INFORMATION MIME ME WoNfnsTiance Company Use
Al. Building Owner's Name WILLIAM COOLEY Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and(or Bldg. No.) or P.O. Route and Box No. .ompany NAIC Number = -
6408 OCEAN ESTATES COURT i •s' -;
City ST. LUCIE State FL ZIP Code 34949
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 4, AVALON BEACH SUBDIVISION
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL L
A5. Latitude/Longitude: Lat. 27°33'03" N Long. 80°19'12" W Horizontal Datum: ❑ NAD 1927 E 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 dr enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspacd or enclosures) N/A sq ft a) Square footage of attached garage 747 sq ft
b) No. of permanent flood openings in the crawlspace or, b) No. of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade I N/A within 1.0 foot above adjacent grade 0
c) Total net -area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? , El E No I d) Engineered flood openings? ❑ Yes E No
SECTION B - FLOODS INSURANCE RATE MAP (FIRM) INFORMATION
Bl . NFIP Community Name & Community Number B2. County Name B3. State
ST. LUCIE COUNTY-120285 ST. LUCIE FLORIDA
B4. Map/Panel Number
B5. Suffix
B6. FIRM IndexFIRM
Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
12111 C0087
J 'I
Date �1�2-16-12
/Revised Date
Zone(s)
AO, use base flood depth)
2-16-12
AO-VE
1 % 2% 14'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM I ❑ Community Determined El Other (Describe)
B11. Indicate elevation datum used for BFE in.ltem 69: ERNGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
B12. Is the building located in a Coastal Barrier Resources SysteI m (CBRS) area or Otherwise Protected Area (OPA)? El Yes E No
Designation Date ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ElConstruction Drawings* ® Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when constructioni, 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. Use the same datum as the BFE.
Benchmark Utilized K-633Vertical Datum NAVD88 I
Conversion/Comments -1.48' NGVD 29 TO NAVD 88
Check the measurement used.
a)
ct
Top of bottom floor (including basement, crawlspace, or enclosure floor) 17.6
E feet
❑ meters (Puerto Rico only)
b)
Top of the next higher floor 1I 29.0
E feet
❑ meters (Puerto Rico only)
c)
Bottom of the lowest horizontal structural member (V Zones only) 14.5
® feet
❑ meters (Puerto Rico only)
d)
Attached garage (top of slab) �i 13.2
E feet
❑ meters (Puerto Rico only)
e)
Lowest elevation of machinery; or equipment servicing the building N/A.
❑ feet
❑ meters (Puerto Rico only)
(Describe type of equipment and location in Comments)
f)
Lowest adjacent (finished) grade next to building (LAG) 11.8
® feet
❑ meters (Puerto Rico only)
g)
Highest adjacent (finished) grade next to building (HAG) 13.6
E feet
❑ meters (Puerto Rico only)
h)
Lowest adjacent grade at lowest elevation of deck or stairs, including 12.5
E feet
❑ meters (Puerto Rico only)
structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification
is to be si ned and sealed b a lad hit th
d
g y n surveyor, engineer, or arc a au orize 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.E
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? E Yes ❑ No
Certifier's Name CHARLES H. BLANCHARD License Number PSM 5755
Title PRESIDENT Company Name MERIDIAN LAND SURVEYORS
BLVU City VFK0 BEACH
LIP Code 32960
Signature ,N�) \ Date 2/24/12, Telephone 772-794-1213
PLACE-,
SEAL
HERE,
FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the espo6ding information from Section A. For Insurance�Corr pony Use
Building Street Address (including Apt., Unit, Suit d/or Bldg. No.) or P.O. Route and Box No.Policy Nunbe7 =i
6408 OCEAN ESTATES COURT
City ST. LUCIE State FL ZIP Code 34949 Company:NAIC!NU rnber
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments THE PRIMARY BENCHMARK USED IS NATIONAL GEODETIC SURVEY CONTROL MONUMENT K-633, ELEVATION= 17.70'NAVD
(ELEVATION= 19.18' NGVD)
oiyiiatu�e; 1 V\\��\Y� Date 2124/12
❑ Check here if attachments
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 E1-E5. If, the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B.
and C. For Items El-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 El meters El 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 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is I. ❑ 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 El feet El 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 uwners or Uwner's Authorized Representative's
Acaress City State ZIP Code
i
Signature j Date Telephone
Comments
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 and G9.
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. ElThe following information (Items G4-G9) is provided for community floodplain management purposes.
G4. Permit Number I 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: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
uommenis
t-tiviA t-orm 81-31, Mar og
Check here if attachments
Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Insurance -Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
6408 OCEAN ESTATES COURT
City ST. LUCIE State FL ZIP Code 34949 Company NAIC Number_
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
�I
FRONT VIEW
Building Photographs
Continuation Page
Fordnsurance
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Numbe
6408 OCEAN ESTATES COURT
City ST. LUCIE State FL ZIP Code 34949 I Company NAIG Nur
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."
NORTHEAST VIEW