The URL can be used to link to this page

Home My WebLink AboutELEVATION CERTIFICATE 6-24-15ib�a,q 11:5 U.S. DEPARTMENT OFHOM LAND SECURITY NATION CERTIFICATE a FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number: I 149 U VISTA COURT City FORT PIERCE State FL ZIP Code 34947 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) METES & BOUNDS DESCRIPTION, TAX ID No. 2407-312-0015-000-1 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDETIAL A5. Latitude/Longitude: Lat. 27.513802 Long.-80.315285 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 1A 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 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 NIA within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in A8.b NIA sq in c) Total net area of flood openings in A9.b NIA 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 B3. State ST. LUCIE COUNTY/120285 ST. LUCIE FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111 C0159 J 02-16-2012 Effective/Revised Date Zone(s) AO, use base flood depth) 02-16-2012 AE 16 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: 1311. Indicate elevation datum used for BFE in Item 139: ❑ 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: [3 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 A7. In Puerto Rico only, enter meters. Benchmark Utilized: MOBIL 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. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 18.10 ® feet ❑ meters b) Top of the next higher floor ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ meters d) Attached garage (top of slab) ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 17.41 ® feet ❑ meters (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) 17.2 ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 17.5 ID feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 17.0 ® feet ❑ 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. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. C❑� 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? ® Yes ❑ No Certifiers Name WILLIAM B. BENNETT License Number 6353 Title LICENSED SURVEYOR Company Name BENNETT SURVEYING, INC. Address 107 AUGUSTA COURT City JUPITER State FL ZIP Code 33458 Signature Date 06-24-15 Telephone 772.336.4933 FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 F . IMPORTANT: In these spaces, copy the cor(-_I. )nding information from Section A. I FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 149 U VISTA COURT City FORT PIERCE State FL ZIP Code 34947 Company NAIL Number:, 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 UNDER CONSTRUCTION CARPORT ELEVATION =17.88 DETACHED CONCRETE STORAGE SHED SLAB ELEVATION = 17.38 MACHINARY I R CONDITIONER PAD AT SIDE OF RESIDENCE Signature Date 06-24-15 SECT16N E BUILRtNG 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. F5r:ltems El_E4; use rlatural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation inforrnat.160oMhe following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grad6 (HAG) and the?owest.Wjacent grade (LAG). a) Top,ofpottom 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 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ 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? ❑ Yes ❑ 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 community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) 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 item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. 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. (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—G10) is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit Issued I 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) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone w.. Signature Date Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions.