HomeMy WebLinkAboutELEVATION CERTTIFICATEU.iS. D�a_ARTMENT OF HOMELAND __11RITY -� OMB No. 1660-0008
Fed(7al Emergency Management Agency SCANNED Expiration Date: November30, 2018
N tonal Flood Insurance Program BY
E LEVATIbi Wdt9t,IFICATE
Important: Follow the instructions on pages 1-9.
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Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
'I SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
1�1.
Building Owner's Name
Policy Number.
S'CHACHINGER
Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number.
Box No.
9:Building
NETTLES BLVD.
City State ZIP Code
JENSEN BEACH FLORIDA 34957
�3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LIDT
987, NETTLES ISLAND PROJECT SECTION 2
'A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
1I 5. Latitude/Longitude: Lat. 27°17'01" Long. 80°13'24" Horizontal Datum: ❑ NAD 1927 ® NAD 1983
�46. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 5
S. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A 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 tt
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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
NINCORP 120285
ST. LUCIE
FLORIDA
B4. Map/Panel
Number
B5. Suffix
B6. FIRM Index
Date
B7. FIRM Panel
Effective/
B8. Flood
Zone(s)
B9. Base Flood Elevation(s)
(Zone AO, use Base Flood Depth)
t ` t
J
d-z11e1/z
Revised Date
aZ!l[o/,z
.A�
�.
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1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
1311. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 19887 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: N/A ❑ CBRS ❑ OPA
�,',EMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
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ELEVATION CERTIFICATE r
OMB No. 1660-0008
-� Expiration Date: November,-3, 201,8
IMPORTANT: In these spaces, copy the'.:.,: Esponding information from Section A.
FOR INSURANCE COMPANY USE
13
ilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number.
9
7 NETTLES BLVD.
C'ty
State ZIP Code
Company NAIC Number
JENSEN BEACH FLORIDA 34957
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
1. 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, V1 V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 A30, AR/AH, AR/AO.
Complete Items C2.a-h below according to the building diagram specked in Item AT 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) 7.68 ® feet ❑ meters
b) Top of the next higher floor N/A ❑ 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 7.8 ®feet ❑meters
(Describe type of equipment and location in Comments)
4.5
f) Lowest adjacent (finished) grade next to building (LAG) ® feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 4•6 ® feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including feet meters 4.4
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.
!
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.
ere latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No ® Check here if attachments.
Certifier's
Name License Number 2782-01-01
E�l
RLE R. STARKEY 004459
itle
PROFESSIONAL LAND SURVEYOR
Name
ACCURIGHT LAND SURVEYING INC.
Company
-
-'dress
A
1501 DECKER AVENUE #419
State ZIP Code 10/29/2018
STUART 1=LORIDA 34994
City
PLS #4459
ature Date Telephone Ext.
�T
10/29/2018 772-286-7694
CI
py all pages of this Elevation chments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments
(including type of equipment and location, per C2(e), if applicable) '
C21E
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A/C PLATFORM
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
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Building Photographs.
See Inst udons for Item A6.
For Insurance Company use:
1 (ding Street Address (hn lx cxJ Apt, Unit, Suite, and/or Bing- No-) or P.O. Route and Box No. Poky Number
9187 NETTLES BLVD.
state ZIP Code canWnyNAicNumber
City JENSEN BEACH FLORIDA 34957
lousing the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
tinstructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View". and, if required, "Right
S'de View" and "Left side Mew." if submitting more photographs than will fit on this page, use the Continuation Page,
f6Ilowing. FRONT 10/29/2018 REAR 10/29/2018
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