HomeMy WebLinkAboutELEVATION CERTIFICATE 8-2-161 1(6 a t
U.S. DEPARTMENT OF HOMELAND S� _ARITY
Fededzi Emergency Management Agency"
Na?.a jal Flood Insurance Program `
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
OMB No. 1660-0008
Expiration Date: November 30, 2018
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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
Policy Number:
McGHEE
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
689 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH FLORIDA 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 689 NETTLES ISLAND PROJECT SECTION!2
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°17'09.8" Long.-80°13'13.5" Horizontal Datum: ❑ NAD 1927 7UZ 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
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A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 767 sq ft
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b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 4
c) Total net area of flood openings in A8.b 800 sq in
d) Engineered flood openings? ® Yes ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garage N/A I 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 openings in A9.b N/A, sq in
'
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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
UNINCORP 120285 -: ; `.
ST. LUCIE
FLORIDA
B4. Map/Panel -
B'5.'Suffix
B6. FIRM Index
B7. FIRM Panel
B8, Flood Zone(s)
B9. Base Flood Elevation(s)
Number
Date
Effective/
(Zone AO, use Base
If 1 `t e-
J
���/�l'Z
Revise ,Date
AE
Flood Depth)
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® z//lo//7-
6.0
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 69: ❑ 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
'i
ELEVATION CERTIFICATE
OMB No. 1660-0008
-� Expiration Date: November 30„ 2018
IMPORTANT: lnjhese spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY
Building Street Address '(irieluding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
689 NETTLES_BLVQ,,,,
City State ZIP Code
Company NAIC Number
JENSEN BEACH FLORIDA 34957
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Buildingelevations are based on: ❑ 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 AT In Puerto Rico only, enter meters.
Benchmark Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 ® 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 5 ® feet ❑ meters
b) Top of the next higher floor 6 6 4 ® 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 3 0 ® feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 4 4 ® feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4 5 ® 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 orimprisonment 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 JOB # 1320-75-01
EARLE R. STARKEY PLS #004459
Title
PROFESSIONAL LAND SURVEYOR
Company Name = ;
ACCURIGHT LAND SURVEYING INC.
Address
1501 DECKER AVENUE #419
City State ZIP Code 08./12/2016
STUART
FL $4994
PLS 4004459
Sig re Date Telephone
2/2016 772-286-7694
Copy all pages of this Elevation Certificate and all attachments 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
FEM'A Form 086-0-33 (7/15) Replaces all. previous editions. ,,Form Page 2 of 6
Building Photograp
See Instructions for Item A6.
or
689 NETTLES BLVD,
City State ZIP Code I c nPanYMAJG
1FNSFN RFACH FLORIDA 34957
If using the Bevation Certificate to obtain NFlP flood insurance, affix at least two building photographs below according. to
the instructions faf 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,
following. FRONT 08/12/2016 REAR 08/12/2016
SIDE 08/12/2016