HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DE
P TM,i T OF HOMELAND J-''` —URITY �) �`�
QF �� OMB No. 1660-0008
Federal Emergency Management Age; Expiration Date: November 30, 2018
` National Flood I3 cfjVP ,9 m - J
4 ELEVATION CERTIFICATE
st-60P ►p 1111 tv Impo rt�nt: Follow the instructions on pages 1-9.
Coav all Daqes of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/cpmpany, and (3) building owner.
SECTION A - PROPERTY INFORMATION .
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Policy Number.
GEORGE & JOYCE VOIGT /
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
505 NETTLES BLVD. I
City State ZIP Code
JENSEN BEACH I Florida 0 34957
_ ^ _ +-
A3. Property Description (Lot and Block Lumbers, Tax Parcel Number, Legal Description, etc.)
LOT 505 NETTLES ISLAND PROJECT SECTION 2
A4. Building Use (e.g., Residential, NonZResidential, Addition, Accessory, etc.) RESIDENTIAL
A5. Lafitude/Longitude: Lat. 27°17'15/5" Long.-80°13'20.9" Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983
A6. Attach at least 2 photographs of he building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 8
A8. For a building with a crawlspace/or enclosure(s):
a) Square footage of crawlsp ace or enclosure(s) '1183. sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 7
c) Total net area of flood op /nings in A8.b 1190 sq in
d)-1ngineered flood openin s? ❑ Yes ❑ No
A9. For a building with an afta :ed garage:
a) Square footage of a �hed garage N/A sq ft
b) Number of permane'tlood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑ Yes ❑x No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORP 12U2'8' ; I
ST. LUCIE
Florida
B4. Map/Panel
Number
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood Zone(s)
B9. Base Flood Elevations)
Date
Effective/
(Zone AO, use Base
,
Revised Date
Flood Depth)
12111 C 0311
J
02/16/2012
02/16/2012
AE
6.0
B10. Indicate the .76urce of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 x❑ NAVD 1988 ❑ Other/Source:
B12. Is the bull ing located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No
Date:
❑ CBRS ❑ OPA
FEMA Form
(7/15)
Replaces all previous editions.
Form Page 1
OMB No..1660-0008
PLEVATION CERTIFICATE Expiration Date:;NoveTher 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:
CRY State ZIP Code Company NAIC Number
1 3 1p�_ 0 -?n. 4 a S -7. 1
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x . 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, ARIA, 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 FDOT Vertical -Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) 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) 43 0 feet ❑ meters
b) Top of the next higher floor 83 0 feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters
d) Attached garage (top of slab) N/A ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 1 ,0 feet
(Describe type of equipment and location in Comments) 6❑ meters
f) Lowest adjacent (finished) grade next to building (LAG) 43 ❑x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 43 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4Z 0 feet ❑ meters
structural support
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is td 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? 0 Yes ❑ No ❑x Check here if attachments.
EARLE R. STARKEY
PROFESSIONAL LAND SURVEYOR
ACCURIGHT LAND SURVEYING INC.
1501 DECKER AVENUE #419
City
License Number
004459
ZIP Code
0 34957
.Iae3 oZao3-01-o q
.dace
big n Date Telephone Ext.
02/17/2017 772-286-7694
Copy all es ev a chments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
C2-E A/C PLATFORM
Form 086-0-33 (7115) Replaces all previous editions.
Form Page 2 of 6
• 3 _.
Building Photographs
see instructions for Item A6.
For In Mnce Comp
I BUi WWM SOW Address (Muding AM, Unit, Su ft/and/or Bldg. No.) or P.O. Route and Box I Pow Nwnaer
505 NETTLES BLVD.
CRY State ZIP Code CaniPO1►NA1CMMM
JENSEN BEACHI FLORIDA 34957
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building, photographs below as ordi . g to
the instructions for Item A&. Identdy all photographa wish: date taken; Front View" and Rear Vew"; 'and, if required, .Right
Wide %Ase W' and 'Lift Wde View." If sub mHting more photographs than will fit on this page, use the Continuation Page,
following. FRONT 02/17/2017 REAR 02/17/2017
SIDE 02/17/2017
U.S. DEPARTMENT OF HOMELAP,;EC
Federal Emergency Management P:y-.;:y
National Flood Insurance Program
EL
CoDv all Dacies of this Elevation Certificate and all
OMB No. 1660-0008
Expiration Date: November 30, 2018
TION CERTIFICATE (�
Follow the instructions on pages 1-9.
tI-
cents 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
Policy Number.
GEORGE & JOYCE VOIGT
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
505 NETTLES BLVD. I
City State ZIP Code
JENSEN BEACH I Florida- 0 34957
+_
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 505 NETTLES ISLAND PROJECT SECTION 2
A4. Building Use (e.g., Residential, Non-Rsidential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°17'15.5" I Long. •80°13'20.9" 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.
A7. Building Diagram Number 8
A8. For a building with a crawispace or e�nclosure(s):
a) Square footage of crawispace oenclosure(s) '1183. sq ft
b) Number of permanent flood ope ings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 7
c) Total net area of flood opening in A8.b 1190 sq in
d) Engineered flood openings? ❑ Yes 0 No
A9. For a building with an attached garage:
a) Square footage of attached;rage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood opengs in A9.b N/A sq in
d) Engineered flood openings ❑ Yes ❑x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORP 120285
ST. LUCIE
Florida 0
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
Revised Date
Flood Depth)
12111 C 0311
J
02/16/2012
02/16/2012
AE
6.0
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No
Designation Date: j ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/115) 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:
S7O S lvo .
City State ZIP Code
Company NAIC Number
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ 0oistruction Drawings* ❑ Building Under Construction' ❑x 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: 94 77 A04 FDOT Vertical -Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source:
Datum used for building elevations must lie 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 ❑ meters
b) Top of the next higher floor I 83 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters
d) Attached garage (top of slab) I N/A ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 6.1 ❑x feet El meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 43. ❑x feet ❑meters
g) Highest adjacent (finished) grade next to building (HAG) 43 x❑ feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
4.2 ❑x feet ❑ meters
structural support
SECTION 131— 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 Cenfiricate 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 SectionlA provided by a licensed land surveyor? Z Yes ❑ No ❑x Check here if attachments.
Certifiees Name License Number
p3 _0
EARLE R. STARKEY 004459
Title I
PROFESSIONAL LAND SURVEYO�
place
Company Name I
ACCURIGHT LAND SURVEYING INC.
i
Address
1501 DECKER AVENUE #419
I
O L t!
City ZIP Code
STU rida 0 34957
Sign Date Telephone Ext.
i 02/17/2017 772-286-7694
Copy all es ev a achments for (1) community official, (2) insurance agent/company, and (3) building owner.
i
Comments (including type of equipment and location, per C2(e), if applicable)
C2-E A/C PLATFORM
FEMA Form 086-0-33 (7/15) j Replaces all previous editions. Form Page 2 of 6
•
. r
505 NETTLES BLVD.
iilding Photographs
See Instructions for Item A6.
or
FLORIDA
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below aocording to
the instructions for Item A6. Identify all photographs with: date taken;'Front View° and °Rear Mew; and, if required, 'Right
Vide M*W and "Left'Side Viewl If submitting more photographs than will fit on this page, .use the Continuation Page,
following. FRONT 02/17/20117 REAR 02/17/2017
SIDE 02/17/2017