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Home My WebLink AboutELEVATION CERTIFICATEU.S. [)EPARTMENT OF HOMELAND SECURITY I� ��✓,�77 OMB No. 1660-0008 Federal Emergency Management Agency t�U I Expiration Date: November 30, 2018 National Flood Insurance Pro ram g 4 9 eiwow(;' ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name I Policy Number: ANINE BIEHL A2. Building Street Address (including Apt., Unit,: Suite, and/or Bldg. No.).or P.O. Route and Company NAIC Number: Box No. 124 QUEEN ANN COURT City State ZIP Code FORT PIERCE FL 34949 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot H, Block 20, QUEENS COVE. UNIT 1, according to the Plat thereof, as recorded in Plat Book 11, Pages 12A through 12C i A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°30'54.91"N I Long.80°18'51.63"W 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 1 B A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) .. NIA sq ft i 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 0 sq in d) Engineered flood openings? ® Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage 400 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 0 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 120285 ST LUCIE COUNTY ST LUCIE FL B4. Map/Panel B5. Suffix B6. FIRM Index. B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base J Revised Date 02/16/12 Flood Depth) 12111 C0089 02/16/12 02/16/12 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® 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 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 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. 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 3494.91 SECTION C — BUILDING ELEVATION' INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: i] Construction Drawings* Building 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 specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: P633 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. F-INGVD 1929 .® NAVD 1988 0 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) 4.33 feet El meters b) Top of the next higher floor N/A EN feet meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A feetEl meters d) Attached garage (top of slab) 3.50 feet meters e) Lowest elevation of machinery or equipment servicing the building 4.25 feet meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 3.05 [ feet meters g) Highest adjacent (finished) grade next to building (HAG) 3.68 PS] feet meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A feet (] meters structural support 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. I understand that any false statement may be punishable by fine or imprisonment under 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. Certifier's Name License Number KENNETH J. OSBORNE 6415 Title r REGISTERED PROFESSIONAL SUVEYOR Company Name C COMPASS SURVEYING Seal Address ere 6250 N MILITARY TRL #102 <61 W It(' City State ZIP Code EST PALM BEACH FL 33407 Signature Date Telephone 07/28/2016 561-640-4800 Copy all pages o leva io and all attachments for(l) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) GARAGE SQ FOOTAGE ROUNDED TO NEAREST 100. ELEVATIONS IN SECTION C2-E ARE ELEVATIONS OF A/C SLAB STORAGE BUILDING IN REAR 4.33' FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 2 of 6 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: 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 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 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. 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 (see pages 1-2 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 ❑ 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 OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATIC3N 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: 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FOR TPIERCE FL 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 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 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 Datum G9. BFE or (in Zone AO) depth of flooding;at the building site: feet 0 meters Datum G10. Community's design flood elevation: El feet meters Datum Local Official's Name Title Community Name 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) Replaces all previous editions. Form Page 4 of 6 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/or Bldg. No'.) or P.O. Route and Box No. Policy Number: 124 QUEEN ANN COURT City State ZIP Code Company NAIC. Number FORT PIERCE FL 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. b •"may. ;6C a .rt�s xr;'l:. d,3�z°:yT'.. ic;,� , • d s g t fi �. k MA'&J o _ g r.y �X nu 9 FORNT VIEW +t.< • [ "`Y.` J 'is ii°M1„tY E�rxrW'we� . r '�� yR 'Y R `�^5. pkiHPj,l. a Jai y°. �„Y#� -� Y L 77 SIDE VIEW FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 t i BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE . 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/or. Bldg. No.) or P.O. Route and Box No. Policy. Number: 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 34949 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."When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. 4. .. aY4 lx CG � hyr K r r i REAR VIEW Photo Two Photo Two Photo Two Caption FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 ELEVATION CERTIFICATE I I � BUILDING PHOTOGRAPHS See Instructions for Item A6. 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: 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 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. t s tf t RI 5� t4 f� - �v� '?� '�e}� 'ti•'a,A� •r _ ~ i r ate.: �tCi`-�'�'tr� 1 a FORNT VIEW ```k Spa. "`5 �` 5 r " � {3, r t ti r.r Y^ • ' �' ,�'' ..� +. 1V • ST t t tr f': �4 � S 'J !F` `�• t•S �."waif � � 1 iC. k1' • 4 t 44 W s.F 4nr" tna . _ 1 i• { 4 1 GJ F I i -yjq 3 SIDE VIEW FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 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/or Bldg. No.) or P.O. Route and Box No. Policy Number. 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 34949 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. • Y '' 4 T p t REAR VIEW Photo Tin/o Photo Two Photo Two Caption FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ti_tVA f IUN CaK I II-IL;A I t wee instrucnons for Rein Ho. txpiration uate: Novemoer Su, zu-iu IMPORTANT: In these spaces, copy the coeresponding 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: 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 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. I FORNT VIEW V,; , [ 'e L � � +� a Y•, et el .c a a °8-' SIDE VIEW FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 . BUILDI_NG PHOTOGRAPHS OMB No. 1660-0008 FI FVATInN CFRTIFICATF Continuation Paae 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: 124 QUEEN ANN COURT City State ZIP Code Company NAIC Number FORT PIERCE FL 34949 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. e � CU ya, jil REAR VIEW Photo Two Photo Two Photo Two Caption FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6