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HomeMy WebLinkAboutELEVATION CERTIFICATE 11-25-14AC-AUW-Dz� U.S. DEPARTMENT OF HOMELAND SECURITY ELt��TS.rJ1RT�F�CATE OMB No. 1660-0008 Federal Emergency Management Agency ExDiration Juiv 31. 2015 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION For Insurance Company Use: A2. Building Street Address (including Apt., Unit, Suite, a 10751 S. Ocean Drive #13-8 City Jensen Beach State FL ZIP Code 34957 Bldg. No.) or P.O. Route and Box No. I Company A3. Property Description (Lot and Block Numbers, Tax Parcel iNumber, Legal Description, etc.) Tax Parcell.D. 4511-311-0837-0004 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. N 27.2689 Long. W 80.2087 Horizontal Datum: ❑ NAD 1927 N 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 ji A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) 1,534 sq It a) Square footage of attached garage 444 sq it b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within 1.0 foot above adjacent grade 4 walls within 1.0 foot above adjacent grade 3 c) Total net area of flood openings in A8.b i 3,791 sq in c) Total net area of flood openings,in A9.b n/A sq in d) Engineered flood openings? © Yes ❑ No d) Engineered flood openings? © Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 133. State Unincorporated Areas 120285 St Lucie I FL 84. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date I Effective/Revised Date Zone(s) AO, use base flood depth) 12111CO314 J 2/16112 2/16/12 AE . 7.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM I ❑ Community Determined ❑ Other (Describe) 611. Indicate elevation datum used for BFE in Item B9: NGVD 1929 ® NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)9 _ ❑Yes ®No Designation Date L-I CBRS ❑ OPA , C- C1. Building elevations are based on: ❑ Constnlctic `A new Elevation Certificate will be required when cons C2. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, below according to the building diagram specified in Ite Benchmark Utilized: _Local BM Indicate elevation datum used for the elevations in items a) through t Datum used for building elevations must be the same as that used fo i Drawings' IN Building Under Construction* L l Finished Construction action of the building is complete. 11430, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g 1 A7. In Puerto'Rico only, enter meters. Vertical Datum: NAVIY88 below. ❑NGVD 1929 ZNAVD 1988 Other/Source: the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawl space, it enclosure floor)- b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment in Comments) 1) Lowest adjacent (finished) grade (LAG) g) Highest adjacent (finished) grade (HAG) h) Lowest adjacent grade at lowest elevation of deli or stairs, including .#a f4., 1 amnnrl -94 ® feet ❑ meters (Puerto Rico only) 7.5Q © feet ❑ meters (Puerto Rico only) n/a. ❑ feet ❑ meters (Puerto Rico only) 33-94 © feet ❑ meters (Puerto Rico only) 7.5 © feet ❑meters (Puerto Rico only) 3.7 ® feet ❑ meters (Puerto Rico only) 3 8 ®feet ❑ meters (Puerto Rico only) 3.8 ® feet ❑ meters (Puerto Rico only) 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 fepresents 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. j Digitally signed by ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a James ` James A. CesiroJr. ❑ Check here if attachments. licensed land surveyor? 0 Yes ❑ No A DN: cn=James A. A Certifier's Name JAMES A. CESIRO, JR. License Number PSM 5543 A. cestroir., o=Atlantic Land Title PRESIDENT Com an Name ATLANTIC LAND DESIGN Design,ou, p y Ces i rO en 11=nLDssa3eg . mall.com c=-Us Address 754 Jensen Beach Blvd. City Jensen Beach State. FL ZIP Code 34957 Jr. Date:2014.11zs / i 1651:54-05'aa FEMA Form 086-0-33 (7/12) fi 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. 10751 S. Ocean Drive #13-8 Policy Number City Jensen Beach State FL ZIP Code 34957 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) communityl official, (2) insurance"agent/company, and (3) building owner. Comments Revised to,reflect elevations per house plans. R Note: - Equipment in C2e = HVAC equipment. Some elevations or dimensions in Sections A8, A9 and C2 arc lrise per county comments 11/25/14 based on Construction Drawings. Signature t Date 11/25/14 ❑ Check here if attachments SECTI E - BUIhDING EL A ON INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El-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. Che& the measurement used. In Puerto Rico only, enter meters., E1. Provide elevation information for the following and check i 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, crawl space, or enclosure) is ❑ feet Elmeters ❑ above or❑'below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is Elfeet ❑ meters Elabove or El below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A.Items 8 and/or 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is I. ❑ 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? El Yes El 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 communitrissued BFE) or Zone AO must sign hen;. The statements in Sections A, A and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's N4. ne Address City State ZIP Code Signature Date Telephone Comments 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. and G9. 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 1 (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.-G9.) is provided for community floodplain management purposes. l G4. Permit Number I G5. Date Permit Issued I G6. Date Certficate Of Compliance/Occupancy Issued I L i G7. This permit has been issued for. El New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: El feet El meters (PR) Datum Local Official's Name. Title Community Name Telephone Signature Date FEMA Form 086-0-33 (7/12) 1 Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See instructions for Item A6. 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 10751 S. Ocean Drive #13-8 City Jensen Beach State FL ZIP Code 34957 con1myNAlCNumber If using the Elevation 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 View" 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: Front View (Date Taken) NA Under Construction F I Lh= C��Y FEMA Form 086-0-33 (7/12) ! Replaces all previous editions. 1 � � ELEVATION CERTIFICATE, page 4 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding W—ul 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 10751 S. Ocean Drive #B-8 CitV Jensen Beach State FL ZIP Code 349571 Canpany NAIC Number If submitting more photographs than will fit on the preo date taken; -"Front View" and "Rear View"; and, if show the foundation with representative example Rear View (Date Taken) NA Under Construe le, affix the additional photographs below. Identify all photographs with: , "Right Side View" and "Left Side View." When applicable, photographs must good ooeninas or vents. as indicated in Section A8. FEMA Form 086-0-33 (7/12) Replaces all previous editions.