The URL can be used to link to this page

Home My WebLink AboutELEVATION CERTIFICATE 7-14-15'U.S. DEPARTMENT OF HOMELAND SECURITY �ML.EVATION CERTIFICATE OMB No.1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY =6 Expiration Date: Jul 31, 2015 National Flood Insurance Prograrn Important: Read the instructions on pages 1-9. p y SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY°USE , Polley Number Nr y ' 4 Al. Building Owner's Name FELIX MOREJON A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number 149 U VISTA COURT City FORT PIERCE State FL ZIP Code 34947 CANNhU 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 G A!i. 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 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 NIA sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No ® SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 34. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111CO159 J 02-16-2012 Effective/Revised Date Zone(s) AO, use base 16flood depth) 02-16-2012 AE B10. Indicate the source of the Base Flood Elevation (131-E) aata or Dase Tiooa aepm emereu ni ltum DU. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. 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) Cl. 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: MOBIL Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 M 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) 17.41 ❑ feet ® feet ❑ meters ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 17.2 ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 17.6 ® 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. [0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 10 Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifier's Name WILLIAM B. BENNETT License Number 6353 Title LICENSED SURVEYOR Company Name BENNETT SURVEYING, INC. Address 107 AUGrUSTA COURT City JUPITER State FL ZIP Code 33458 Signature Date 07-14-15 Telephone 772.33(JAW;J FEMA Form 086-0-33 ('/12) See reverse side for continuation. Replaces all previous ealtlons. ELEVATION CERTIFICATE, page 2 - IMPORTANT: In these spaces, copy tht>,_rFlresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. "I?0110y"Number. 149 U VISTA COURT - City FORT PIERCE State FL ZIP Code 34947 Company NAIC:Num, 6er. 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 IS AIR CANpITIONER PAD AT SIDE OF RESIDENCE Signature — Date 07-14-15 SECTIONi E�UILDIsVG'i LEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El—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. El. 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 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 nrdinance? n Yes M 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 G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 1506-0105 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 Signature Date Comments Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. , FRONT VIEW DETACHED SHED SIDE VIEW REAR VIEW SIDE VIEW SIDE VIEW DATE OF PHOTOS: 06-17-2015 Bennett Surveying, Inc. Job No. 15-0627