HomeMy WebLinkAboutELEVATION CERTIFICATEFEDERAL EMERGENCY MANAGEMENT AGENCY
S NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
~t J Expires December 31, 2005
ELEVATION CERTIFICATE'S �'
sly
ImporW., Read the Instructions on pages
SECTION A - PROPERTY OWNER INFORMATI ` ` " a lrisuranoe Company.use:
BUILDING OWNER'S NAME Policy Number
BILTMORE COMMERCIAL PARK, LLC ,
BUILDING STREETADDRESS (Including Apt., Unit, Suite, andfoir Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
3763-3781 OLEANDER AVENUE (BUILDING1)
CITY STATE ZIP CODE
FORT PIERCE I FIL
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Pa i I Number, Legal Description, eta)
A PORTION OF SECTION 33 TOWNSHIP 35 RANGE 40
BUILDING USE (e.g., Residential, Non-residential, Addition, Acc sory,, eta Use a.Comments area, if necessary.)
COMMERCIAL
LATI7UDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM:, SOURCI=: ❑ GPS (Type):
##.#N' or ❑ NAD 1927 0 NAD 1983 [1 USGS Quad Map ❑ Other.
SECTION B -,FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
I UNINCORPORATEDAREA 120285 I I ST. WCIE I FLORIDA
84. MAP AND PANEL
�
E17. FIRM PANEL
B9. BASE FLOOD ELEVAMON(8)
NUMBER
B5. SUFFIX
B8. FIRM INDEX DATE
EFFECTIVFJREVISED DATE
B8. FLOOD ZONES)
goneAO, use depth of flooding)
12111CO189
F
BMW I
11102
XIAE
19
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile ® FIRM' ❑ Community Determined ❑ Other (Describe):
B11. Indicate the elevation datum used for the BFE in 139: ® NGVD 1,929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the butldinu located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Constriction Drawings' I ❑ building Under Construc ion" ® Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number I (Select the building diagram most similar, tolhe building for which this certificate is being completed - see pages 6 and 7. K no diagrarn
accurately represents the building, provide a sketch or photograph.)
C3. Elevations — Zones Al A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARIAE, ARIA1 A30, ARIAH, APJAO
Complete Items C3.-a4 below according to the building diagram' specified in Item C2. State the datum used, ff the datum is different from the datum used for the BFE in
Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the spade provided or the Comments area of
Section D or Section G, as appropriate, to document the datum 6onversion.
Datum NGVD1929 ConversionlComments
i
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ❑ No
o a) Top of bottom floor (including basement or enclosure) 14. OB ft.(m)
o b) Top of next higher floor NIA. ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only) WA. ft.(m)
09
o d) Attached garage (tap of slab) NA. ft•(m)
E
o e) Lowest elevation of machinery andlor equipment
W
ft
servicing the building (Describe in a Comments area) I r a - .(m)
E ; i
o f) Lowest adjacent (finished) grade (LAG) 13.4 ft.(m)
z .
o g) Highest adjacent (finished) grade (HAG) 13. 83 ft•(m)
C
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade NIA
B
o i) Total area of aJI permanent openings (flood vents) in CH, NIA sq. in. (sq: am)
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 ceifify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
i understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIERS NAME ROBERT BLOOMSTER JR LICENSE NUMBER 4134
TITLE PROFESSIONAL LAND SURVEYOR COMPANY NAME BLOOMSTER PROFESSIONAL LAND SURVEYORS, INC.
ADDRESS
DU(IEMIGH1DlAY /�// c1 // JE SEN BEACH FL
4
P CODE
791 N957
8/29/06 772334-M
FEMA Form 81-31, January 2003 1 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A 1,*For Insurance Company use:
BUILDING STREET ADDRESS (Including Apt, Unit Suite, ai Ig. No.) OR P.O. ROUTE AND BOX NO. . , _ Policy Number -
OLEANDERAVENUE ns'
CITY • • „ STATE ZIP CODE I Company NAIL Number ' I
Fr. PIERCE „ ' r FL
'SECTION b ."SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificatefor (1) community official, (2) insurance agentloompany, and (3) building owner.
COMMENTS
Check here if
SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
ForZone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
El. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed —see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is _ it(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6$ with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ft.(m) _in.(an) above the highest adjacent
grade. Complete items C3.h and C31 on front of form.
E4. The top of the platform of machinery and/or equipment servicing the building is. _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E5. ForZoneAO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the communitys floodplain management ordinance?
❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F -
The property owner or owners authorized representative who completes Sections A, B, C (Items C3.h and C3.1 only), acid E for Zone A (without a FEMA-issued or community -
issued BFE) or Zone AO must sign here. The statements in Seclrons A, A C, and E are correct to the best ofmy knowledge,
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY ISTATE ZIP CODE
SIGNATURE DATE
COMMENTS
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
Check here if
The local official who is authorized by law or ordinance to administer the oommunity'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.
G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local 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 FEMAassued or community4ssued BFE) or Zone AO.
G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes.
G8. Elevation of as -built lowest floor (including basement) of the building is: _. _ft.(m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum:
LOCAL OFFICIAL'S NAME _ TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions
FEDERAL EMERGENCY. MANAGEMENT AGENCY
NATIONAL'FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
:! Expires December 31, 2005
5�5 ` ELEVATION CERTIFICATE
Important:. Read the Instructions on pages I.7.
SECTION A- PROPERTY OWNER INFORMATION Forinsurarioe.Cornpanyuse
BUILDING OWNERS NAME Policy Number
BILTMORE COMMERCIAL PARK, LLC
BUILDING STREETADDRESS (Including Apt., Unit, Suite, andtoBldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Numbe_ r.
3763-3781 OLEANDER AVENUE ( BUILDING 1)
CITY STATE ZIP CODE
FORT PIERCE I FL
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc )
A PORTION OF SECTION 33 TOWNSHIP 35 RANGE 40
COMMERCIAL
LATTIUDEILONGITUDE (OPTIONAL) -HOF
( ##° - ##' - ##.##' or ##.##ON) ❑ NAD
Use a Comments area,
❑ NAD 1983
SECTION B • FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
❑ Other.
I UNINCORPORATEDAM 12M I ST. WCIE I FLORIDA I
84. MAP AND PANEL
I
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUNBER
B5. SUFFIX
B6. FIRM INDEX DATE
EFFECTIVEMSED DATE
BB. FLOOD ZONES)
(ZoneAO, use depth of flooding)
12111CO189
F
.680 I
1114)92
i XIAE
10'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe):
B11. Indicate the elevation datum used for the BFE in 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the buildino located in a Coastal Barrier Resources System (CBRS) area or Olherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date
SECTION 't - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1, Building elevations are based on: ❑ Constriction Drawings* I ❑ Building. Under Construction* 0 Finished,Constnucion
*A new Elevation Certificate will be required when construclion of the building is complete.
C2. Buldiing Diagram Number I (Select the building diagram most similar to the bulding for which this certificate is being completed - see pages 6 and 7. N no diagram
accurately represents the building, provide a sketch or photograph.)
C3. Elevations — Zones Al A30, AE, AH, A (with BFE), VE, VI430, VI (with BFE), AR, ARIA, ARIAE, ARIA1 A30, ARIAH, ARIAO
Complete Items C3.-a4 below according to the building diagram specified in Item C2. State the datum used. ff the datum is different from the datum used for the BFE in
Section B, convert the drum to Mused for the BFE. Show field'measurements and datum conversion calculation. Use the space provided orthe Comments area of
Section D or Section G, as appropriate, to document the datum conversion.
DatumNGVD1929 Conversion/Comments—
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? []Yes ❑ No
o a) Top of bottom floor (including basement or enclosure) I 14. 06 ft.(m)
o b) Top of nett higher floor NIA. 8.(m)
o c) Bottom of lowest horizontal structural member (V zones only)09
o d) Attached garage (top of slab) WA. _ft.(m) W
o e) Lowest elevation of machinery andlorequipment
servicing the building (Describe in a Comments area)
o f) Lowest adjacent (finished) grade (LAG) 13.4 ft(m) z'
o g) Highest adjacent (finished) grade (HAG) 13. 89 it.(m) y tj
o h) No. of permanent openings (flood vents) within 1 ft. above'adjacent grade NIA `l
J o t) Total area of all permanent openings (flood vents) In C3.h NIA sq. in. (sq. cm)
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 in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIERS NAME ROBERT BLOOMSTER JR. LICENSE NUMBER 4134
TITLE PROFESSIONAL LAND SURVEYOR COMPANY NAME BLOOMSTER PROFESSIONAL LAND SURVEYORS, INC.
ADDRESS
DIXIEXtj . �w (} JE SEN BEACH FLATE 4PDE
791 N
8I29I06 772-334MM
FEMA Form 81-31, January2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT, In these spaces, copy the corn;
BUILDING STREET ADDRESS (Inducting Apt, Unit, Suite, ai'
My
FT. PIERCE
SECTION D -
information from Section A
OR P.O. ROUTE AND BOX NO.
STATE
Fl_
ENGINEER, OR ARCHITECT
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner.
COMMENTS
For Insuranoe Company Use:
Policy Number
U Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
ForZone AO and Zone A (without BFE), complete items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
El. Building Diagram Number —(Select the building diagram most similar to the building for which this certificate is bang completed —see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (Including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or [:]below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6.8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(cm) above the highest adjacent
grade. Complete items C3.h and C31 on front of form.
E4. The top of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E5. For 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, C (Items C3.h and C3.1 only), and E for Zone A (without a FEMA4ssued or community -
issued BFE) or Zone AO must sign here. The statements in Sections A, A C, and E are com:d to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
__ _ _ ❑ Check here if attachments
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.
G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local 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 FEMA4ssued orcommunityassued BFE) or Zone AO.
G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes.
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: ft.(m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _.'_ ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE
COMMENTS
❑ Check here if attachments
FEMA Form 81-31, January 2003 , Replaces all previous editions
FE 1AL EMERGENCY MANAGEMENT AGI ' Y
._nONAL FLOOD INSURANCE PROGR)
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
O.M.B. No. 3067-0077
Expires December 31, 2005
' SECTION A - PROPERTY OWNER INFORMATION Forlri§u"rance.Gimnanv%LJsPf w
77
BUILDING STREET ADD ESS (In uding Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company°NAICNumberx
j� STATE G ZIP CODE
�Q
ROPE TY DESCRIPTION (Lot and Block Nu bers, T. Parcel Number, Legal Description, etc.)
B ILDIN USE (e.g., Residential, Non-residential, Addition, Acceslsory, etc. Use a Comments area, if necessary.)
y '0
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1-1 GPS (Type):
y
or ##.##gW) 1_1 NAD 1927 ll I NAD 1983
7 1_1 USGS Quad Map 1_1 Other
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP' `COMMUNITY NAME & COMMUNITY NU 3ER B2 CO TY NAME B3. STATE
B4. MAP AND PANEL
NUM BERG/
B5. SUFFIX
B6. FIRM INDEX
DATE
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATIONS)
EFFECTIVE/REVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
1-1 FIS Profile I_?_�l RM 1_1 Community Determined IJ Other (Describe):
B11. Indicate the elevation datum used for the BFE in 139: I1L1'K6VD 1929 I —I NAVD 1988 1-1 Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes I o `
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based .on: 1_1Construction Drawings* I —(Building Under Construction* 1_1Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. 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 C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used I Does the elevation reference mark used appear on the FIRM? 1_1 Yes 1_1No
❑ a) Top of bottom floor (including basement or enclosure) _
ft.(m)
❑ b) Top of next higher floor _
❑ c) Bottom of lowest horizontal structural member (V zones only)
ft.(m)
ft.(m)
CD
_
❑ d) Attached garage (top of slab)
ft.(m)
a o
E c
_
❑ e) Lowest elevation of machinery and/or equipment
W d
servicing the building (Describe in a Comments area.)
ft.(m)
M
_
❑ f) Lowest adjacent (finished) grade (LAG) _
ft.(m)
zgm
❑ g) Highest adjacent (finished) grade (HAG)
ft.(m)
N
_
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
8
J
❑ i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm)
stV i FUN U - 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 in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
TITLE COMPANY NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
=EMA Form 81-31, January 2003 See reverse side for continuation. Replaces all nrPvinim ariitinnc