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HomeMy WebLinkAboutELEVATION CERTIFICATE 107-13U.S. DEPARTMENT OF HOMELAND.SECURITY ELEVATIQN CERTIFICAT OMB No. 1660-0008 0ED4r EMERGENCY MANAGEMENT AGENC( National Flood Insurance Program important: Read the instructions on pages--I'--9. Expiration Date: July31, 2015 SECTION A - PROPERTY INFORMATION Al. Buildina Owner's Name WAYNE THOMAS mom A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. ; iF �t .1 i fe a ►� 63 NETTLES BLVD.' City JENSEN BEACH State FL ZIP Code 34957Qa����j) h A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) DI LOT 63, NETTLES ISLAND PROJECT SECTION 2 � 'yLot WaflQQ RESIDENTIAL A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 27*17'11.5" N Long. 80*13'39.8" W Horizontal Datum: ❑ NAD 1927 0 NAD 1983 Hori 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 enclosure(s): A9. For a building with an attached. garage: a) Square footage of crawlspace or enclostre(s) N/A sq ft a) Square footage of attached garage 442 sq ft b) Number of permanent flood openings in the crawlspace I b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade 3 c) Total net area of flood openings in A8.b N/A sq.in c) Total net area of flood openings in A9.b 845 sq in d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes N No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 62. County Name I B3. State UNINCORP 120285 ST. LUCIE FL B4. Map/Panel Number I B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111C 0311 J 02/16/2012 Effective/Revised Date Zone(s) AO, use base flood depth) i 02/16/2012 AE 6.0 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile N FIRM ❑ Community Determined ❑ Other/Source: , B11. Indicate elevation datum used for BFE in Item B9:, ❑ ( NGVD 1929 P9 NAVD 1988 ❑ Other/Source: - B12. Is the building located in a Coastal Barrier Resources System CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes No Designation Date: _ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl.* Building elevations are based on: ❑ Construction Draiwings* ElBuilding Under Construction* 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 specked in Item A 1. In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 NNAVD 1988 ElOther/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) 6.65 feet ❑ meters b) Top of the next higher floor 16.2 feet ❑ feet ❑ meters ❑ c) Bottom of the lowest horizontal structural member (V Zones only) N/A._ meters d) Attached garage (top of slab) 5.1 ❑X feet feet ❑ meters ❑ e) Lowest elevation of machinery or equipment servicing the building 5.65 meters (Describe type of equipment and location in Comments) feet ❑ f) Lowest adjacent (finished) grade next to building (LAG) 4.8 feet meters ❑ g) Highest adjacent (finished) grade next to building (HAG) 5.1 ❑ meters ❑ h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A._ 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.) certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. . 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by -a . ' 0 Check here if attachments. licensed land surveyor? ❑X Yes ❑ No Certifier's Name EARLE R. STARKEY License Number 004459 - Title PROFESSIONAL LAND SURVEYOR C ante ACCURIGHT LAND SURVEYING INC. ,q 1501 DECKER AVENU r• J' RT I - State FL ZIP Code 34994 �+ _ , ;� .- 1265-36-01 P 10/07/2013 PLS #4459 'S' a Date 10/07/2013 Telephone, 772-286-7694 FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. top Building Photographs See Instructions for Item A6. For Insurance Company Use: f BuildiFm Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.a. Route and Box No. pony Numbef 63 NETTLES BLVD. City state ZIP Code C«npa VUWNumber .JENSEN BEACH FLORIDA34957 If using the Sevation 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 VievW' 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. FRONT 10/07/20.13 11 SIDE 10/07/2013_.._...._ _ --_11 Building Photographs See Instructions for Item A6. For Insurance Company Use: f BuildiFm Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.a. Route and Box No. pony Numbef 63 NETTLES BLVD. City state ZIP Code C«npa VUWNumber .JENSEN BEACH FLORIDA34957 If using the Sevation 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 VievW' 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. FRONT 10/07/20.13 11 SIDE 10/07/2013_.._...._ _ --_11 i Building Photographs CoMhuation. Page BuiWi StreetAddtess (incCt�ding Apt.,.Unit, Suite and/or Bldg. No.) or P.O. Route and Box No. ng Is3 NETTLES BLk-lI} city state ZIP Code .►;laic nxsier . ; JENSEN $EACH FLORIDA 34957 If submitting more .photographs than will fit on the preceding page, affix the additional photographs below. Identity all photographs with: date taken; 'Front View" and'Rear .View'; and, if required, Right Side View' and Left Side View. 39 REAR 10/07/2013 �' SIDE 10/07/2013 (� ►JELEV.-TION CERTIFICATE, page 2_ - IMPORTANT: In these spaces, copy the' sponding information from Section A. Building Street Address (including Apt., Unit, Surte� and/or Bldg. No.) o� P.O. Route and Box No. _ 63 NETTLES BLVD. City JENSEN BEACH State FL ZIP Code 34957 SECTION D — SURVEYOR, ENGINEER,- OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community offici insurance agent/company, and (3) building owner. Signature EARLE KEY Date 10/07/2013 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 E7—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 openings provided in Section A Items 8 and/or 9 Lee pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet El meters Elabove 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 _._ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO oni : 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 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 items) 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 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 G4-010) is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit Issued G7. This permit has been issued for: ❑ New Construction G8. Elevation of as -built lowest floor (including basement) of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: G6. Date Certificate Of Compliance/Occupancy Issued Substantial Improvement ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum _ ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments.