HomeMy WebLinkAboutELEVATION CERTIFICATE 9-1-1617.J. L1Li-iAi i IYii-iV i Vi I iuivir-LAND
Federal Emergency Management Agency
1 Nation'al Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
OMB No. 1660-0008 ^�
Expiration Date: November 30, 2018
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" Llong.-80°13'13.5" 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 8
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 767 sq ft
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 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
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
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
AE
Flood Depth)
6.0
B10. 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 :B9: ❑ 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 Pagel of 6
ELEVATION CERTIFICATE
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Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy ti�.�i',3orresponding 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:
689 NETTLES BLVD.
City State ZIP Code
Company NAIC Number
JENSEN BEACH FLORIDA 34957
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations 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, 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 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
I
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.
l 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
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
FL 34994
!BLS #004459
Signa Date Telephone
08/12/2016 772-286-7694
Copy all page this a 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)
A8-D FLOODVENT MODEL # 1540-520 C2-E A/C PLATFORM
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
�} Building Photographs
See 'Instructions for Item A6.
For Insurance Company Use:
Building SUM Address (Mudmg Apt., Unit Suite, andlot Bftg. No.) or P.O: Route and'Box No. Policy Number
689 NETTLES BLVD,
city JENSEN BEACH Sete FLORIDA Z134957 �
If using the Elevation. Certificate to obtain NFIP flood insurance; affix at least two building photographs .below atxording to
the. instructions #or item AB. identify all photographs with: date taken; "Front yieW—'and "Rear View";.and, if required, "Right
Side view' and "Left Side View." .ff submitting More' photographs than will fit on.this page, Use the Continuation Page,
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