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HomeMy WebLinkAboutELEVATION CERTIFICATE 3-1-16U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program Al E VA 1`10N C EN T i1=iGA1E Important: the instructions on pages 1-9. A - PROPERTY INFORMATION �5wy0 _zaa __ OEM B-Nor�:664g0.008 Expiration Date: July 31, 2015 A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg:1No.) or P.O. Route and Box No.nrpar u g r ... 581 NETTLES BLVD. ` 0,40,0 w�0101M0 c =3 e City JENSEN BEACH 4 State FL ZIP Code 34957 Qe anennen,a� . A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 581, NETTLES ISLAND PROJECT SECTION 2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) 1, r 11 rr RESIDENTIAL A5. Latitude/Longitude: Lat. 27°17'12.7" N Long. 80*13'23.8" W Horizontal Datum: ❑ NAD 1927 ❑X 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 1 B A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes N No d) Engineered flood openings? ❑ Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name &Community Number TBT2..Coun ty Name B3. State UNINCORP 120285 LUCIE FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7.',FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111 C 0311 J 02/16/2012 Effective/Revised Date Zone(s) AO, use base flood depth) 02/16/2012 AE 6.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑X FIRM ❑ Community Determined ❑ Other/Source: 1311. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 1X1 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: _ Ll CBRS T1 OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑X 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 AT In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 88 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. l; Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 6.0 © feet ❑ meters b) Top of the next higher floor _ _ ?C❑ 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._ IN feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building N/A._ ❑ feet, ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.0 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 structural support N/A._ ❑ feet n meters 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. 2368-01-01-1.11C I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001_ ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a-` ❑ Check here if attachments. licensed land surveyor? ❑X Yes ET -No PLACE SEAL Certifier's Name EARLE R. STARKEY License Number 004459 Title PROFESSIONAL LAND SURVEYOR Company Name ACCURIGHT LAND SURVEYING INC. Address 1501 DECKER AVENUE #419 City STUART State FL ZIP Code 349 Signature EARLE R. STARKEY Date 03/01/2016 Telephone FEMA Form 086-0-33 (7/12) See reverse side for continuation PLS #4459 Replaces all previous editions. ELEVATI'ON CERTIFICATE, pal:,- -_7� IMPORTANT: In these spaces, copy orresponding information from Section �y -' FOR;]INSUkkNCECOMPAW-JiSE; Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. P�Gy NW?r 738 NETTLES BLVD. } City JENSEN BEACH State FL ZIP Code 34957 Cgii�panyNAlClum6er ,ar SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. -Comments_ Signature EARLE R. STARKEY Date 03/01/2016 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO,and A (without BFE), complete Items E1—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. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check 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, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑-above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 91see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters' ❑ above or IJJ below the HAG. E3. Attached garage (top of slab) is _ _ Elfeet' ❑ meters ❑ above or El below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _,�❑.f--—n----'—ve or D below the HAG. E5. Zone AO only: If no flood depth number is availa the community's floodplain management ordinance? ElYes ElNo ElUnknown. The SECTION F — PROPERI 'TIFICATION The property owner or owner's authorized representativi =MA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections, 6 Property Owner's or Owner's Authorized Representafive', Address Signature ZIP Code Comments 1 ll 4 s I ❑ Check here if attachments. SECTION G — l The local official who is authorized by law or ordinance to administi ;,mplete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sig In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other docu�,, —gri d and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (India rand 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—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement 'G8. Elevation of as -built lowest floor (including basement) of the building: _ _ ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) d;epth,of flooding at the building site: _ _ ❑ feet ❑ meters Datum G10. Community's design floi�d_elevation: _ _ El feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature _ Date Comments ❑ Check here if attachments. Planning & DeveloPiment services Building & Code Regulation Division 2300 VirginliAve Fort Pierce, FL, 82 772-462-2172 Fax 773^462-6443 CERTIFICATE OF T1 CONSTRUCTION PERM' #: S ' L JOB ADDRESS: BUILDER/CONTRACTOR: PEST CONTROL, CONTRACTOR. - PEST CONTROL LICENSE #:_� TE TRFCATM ENT TREATMENT We, the undersigned, hereby certify that we have pretreated the above described Construction for subterranean termites in accordance/with the standards of tiie National Pest Control Assodation. Cl�� ll� �/ Square feet if area treated:.•- Chemi Lis used: a Percentage of solution: • O6' Total gallons used: 6`0 Date of Treatment: 3 J r 4 /e -- Footing 19t Treatment Re Treat Driveway s 1s' Treatment Re -Treat Other 1� Treatment Re -Treat I Time of Treatment: i % a 6 Stab . 1t Treatment Re -Treat Aools ' 1m Treatment Re -Treat Perimeter for Final Inspection g_ � Z Signature of F.xtermingdr Note: Mare must be a completed form for each required treatment arre-inwi mentand this farm must be on the job site to be picked up by the Inspector at time of garb Inspedlon or the scheduled Inspecu'on will fall and a re•/nspectlon 6W .f,1r.9� FBC104.2.6 Cerdfrmte Offttecdvs Treatmentforpreventlon of termites A weatherreslstant jobsite posting board Shall be provlded fi receive duplicate Treatment eerulkates as each, regzffred protxYve t whmntis completed, providing a copy for the person the permit is issued to and another copy for to bullding permit files The TWIment certificate shall provide the product used, identify of the applIcator, Arne and date of the treatment, site location, area treated, dtemical used, percent mncentration and number of gallons used, tri establish a vedfrable record of protective treatment. if the soil Cher Wcalbarrlermeftdfortermltepreventfon PCs urea; Anal ewayor treatment shall be completed prior to final bullding approval. St Lucie County requires for the final Inspection for CO,', a permanent Stacker to be Placed on the electrical panel box cover, listing all the treatments and dates of applications,