Loading...
HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DEPARTMENT OF HOMELAND SECURITY t"',L t V A,1 ! O N C: C K I l t l C:A I t, FEDERAL EMERGENCY MANAGEMENT AGENCYt .t ` OMB No. 1660-0008 NationalFloodlnsuranceProgram Important: Read the instructions on'ages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION Al. Building Owner's Name ALAN & MARTHA WEINERMAN A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 526 NETTLES BLVD. City JENSEN BEACH i State FL ZIP Code 34957 9 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 526, NETTLES ISLAND PROJECT SECTION 2 ��f g 2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) %7LW6Uk Illf-T " If RESIDENTIAL A5. Lafitude/Longkude: LaL 27.287163 N Long. 80.223798 W I Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 8 'i A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 855 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade 8 I within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b 900 sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes 0 No d) Engineered flood openings? ❑ Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 62.E County Name B3. State UNINCORP 120285 STHUCIE I FL B4. Map/Panel Number B5. Suffoc FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111C 0311 J P6. I 02/16/2012 Effective/Revised Date Zones) AO, use base flood depth) 1 02/16/2012 A 6.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Rem B9. ❑ FIS Profile 0 FIRM ElCommunity Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ElNGVD 192I9 .0 NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date: _ I CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction- 0 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, Vi 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. 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 Ih) below. ❑ NGVD 1929 0 NAVD 1988 ❑ Other/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) 4.3 0 feet El meters b) Top of the next higher floor 8.4 0 feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A._ ❑ feet ❑ meters d) Attached garage (top of slab) NN/A., ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 6.8 0 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.2 0 feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.3 0 feet ❑ 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. I certify that the information on this Certificate represents my best efforts to interpret the data available. 2295-01-01 1 understand that any false statement may be punishable by fine orimprisonment under 18 U.S. Code, Section 1001. © 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? 0 Yes ❑ No .. - Certifiers Name EARLE R STARKEY License Number 004459 Titre PROFESFAlAt17RD SURVEYOR y Name ACCURIGHT LAND SURVEYING INC. Address 1501 DECM8 A City STUART State FL ZIP Code 34994 Signature EARZE R. ST 't' Date OSI26/2015 Telephone 772-286-7694 1 03/26/2015 PL-S #"59 3LEVA )ONNisCERTIFICATE page 2 i ! �) IMPORTANT: In these spaces, copy the c fpo�n­dang information from Section A. H Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.�`ia� 526 NETTLES BLVD. .:i,,r�hs City JENSEN BEACH State FL ZIP Code 34957 SECTION D — SURVEYOR. ENGINEER. OR ARCHITECT CERTIFICATION (CONTINUEDI Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments C2-E A/C PEDESTAL Signature EARLE R. STARKEY Date 03/26/2015 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 E1—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, crawispace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or El 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 91see pages 8-9 of Instructions), 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 _ _ ❑ feet ❑ metersi ❑ 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 music 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 c6rrect to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name I 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 communityrs floodplain management ordinance can complete Sections A, B, C (or E), and C of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8--010. 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—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit 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 Datum _ G9. BFE or (in Zone AO) depth of flooding at the building site: _ ❑ feet ❑ meters Datum _ 310. Community's design flood elevation: _ ❑ feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments. 1.526 NETTLES BLVD. BtAil!ing Photographs Instructions far Aern A6. or P-0- RoWezrmJ FLORIDA If using the Bevaboh -Certificate lo obtwn NOPlood imurance, affifix at leikst two building -photographs below according to the Instructions for Item. Ae. Identify all :pNtograohswith:.ddtia taken; 'FroTit-VieWand"Rear *VieveR,and, if requiried, 'Right Sida. View" and "Left Side View-' It sut)rsiffflrj§ More,photographs 11h rii Wul fit 0h .1 ftafion Page, - this P046, usa the �Cop followin.q. FRONT 03/26/2015 j REAR 03/26/2015 IDE 03/26/2015