HomeMy WebLinkAboutELEVATION CERTIFICATE 2-16-12�'- —" UM[3 No. 1660-0008
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Federal Emergency Management Age s 1 , Expiration Date: November 30, 2018
National Flood Insurance Rvigram
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Co Y all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
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SECTION A — PROPERTY INFORMATION ^^A f,aiaak--, ,
FOR INSURANCE COMPANY USE
Al. Building Owner's Name WWrWQ§VftKzf
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Policy Number:
RICHARD MURRAY �., ...eta:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. N • .) R.V 9 d
Company NAIC Number:
Box No.
581 NETTLES BLVD.
City State ZIP Code
JENSEN BEACH FLORIDA 34957
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 581 NETTLES ISLAND PROJECT
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 27°17'12.7"N Long.-80°13"23.8"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 8
A8. For a building with a crawispace or enclosure(s):
a) Square footage of crawispace or enclosures) 51.2 sq ft
b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A8.b 400 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
Effective/
B8. Flood Zone(s)
B9. Base Flood Elevation(s)
(Zone AO, use Base
Number
Z
1 i i i C
J
Date
®Z/11o� 1 Z
Revised Date
AE
Flood Depth)
t� z. 1 1l0 l 1Z_ ,
6.0
1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69:
❑ 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 rage i ui o
ELEVATION CERTIFICATE 1
Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copi c,_. iesponding information from Section)
FOR IN,9,URANCE COMPANY -USE '
Building Street Address (including Apia, unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number. �• j
581 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 khen`constiik1ion 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 accordinglto 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, crawispace, or enclosure floor) 4 2 ® feet ❑ meters
b) I op of the next higher floor 6 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 6 7 ® feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 4 0 ® feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4 1 ® feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ 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. l 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 #2568-01-01 -
EARLE R. STARKEY PLS #004459
Title
PROFESSIONAL LAND SURVEYOR
Company Name
ACCURIGHT LAND SURVEYING INC.
Address
1501 DECKER AVENUE #419
09/27/2016
City STUART State ZIP Code
FL 34994
PLS #004459
Signature Date Telephone
. 27/2016 ' 772-286-7694
Copy all page evation 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)
A8-A IS A NON LIVING STORAGE ROOM. A8-E FLOOD VENT MODEL #1540-520 C2-A NON LIVING STORAGE
ROOM • C2-B IS THE LIVING AREA THERE'S A SECOND STORY ELEVATION 15.4 C2-E A/C PLATFORM
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
luilding Photographs -
See instructions for Item A6.
For Insurance Company Use.:
BuilQing - rc t 4dtdreSs (Wu—c ing Apt., Unit, Suite, and/or Mg. No.) or P.O. Route and Box No. Policy Number
531 NETTLES BLVD,
City state ZIP Code carpmyWr MMIM
JENSEN - BEACH FLORIDA _ _ _34957
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two buildings photographs below according to
the instructions for Item AF. Identify all -photographs with: date taken;. "Front View" and "Rear View"; and, if required, "Right
Side Viem/' and "Left Side Viow." If subinitting more photographs than Wilt fit. on this page, Use the Continuation Page,
following. FRONT 09/27/2016 REAR 09/27/2016
F --
DE 09/27/20