HomeMy WebLinkAboutELEVATION CERTIFICATE 11-21-18SCANNED 0
U.11-DEPARTMENT OF HOMELAND Sf __'RITY OMB No. 1660-0008
Fe�eral Emergency Management Agency S� Lucicounty t2!
Expiration Date: November 30, 2018
Na4rial Flood Insurance Program % I / j / / 8
6
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
,1. Building Owner's Name
Policy Number:
D.R. HORTON INC.
i1
2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
8717 COBBLESTONE DR.
City State ZIP Code
FORT PIERCE Florida 34945
Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
�IA3.
2326-600-0045-000-6 LOT 40
i A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
IA5. Latitude/Longitude: Lat. 27°24'36.04" N. Long.80°24'54.63" 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 1A
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
Lb) 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 ❑X No
A9. For a building with an attached garage:
a) Square footage of attached garage 400.00 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 Fx� No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
132. County Name
B3. State
St. Lucie County 120285
Saint Lucie
Florida
B4. Map/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s)
Number
Date
Effective/
Zone(s)
(Zone AO, use Base Flood Depth)
Revised Date
12111 CO170
J
02-16-2012
02-16-2012
AE
16.5
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 139: ❑ NGVD 1929 X❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of`6\\
�I -
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMI?IORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
87�17 COBBLESTONE DR.
Cq State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34945
q
�I SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
u
C1. Building elevations are based on: ❑ Construction Drawings* ❑x Building Under Construction* ❑ Finished Construction
it *A new Elevation Certificate will be required when construction of the building is complete.
I12. Elevations — Zones Al—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, ARM, AR/AE, AR/A1—A30, AR/AH, AR/AO.
I Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
i Benchmark Utilized: AF6653 Vertical Datum: NAVD 88
j Indicate elevation datum used for the elevations in items a) through h) below.
i
❑ NGVD 1929 ❑x 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)
18.45 ❑x feet ❑ meters
b) Top of the next higher floor
N/A ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member N Zones only)
N/A ❑ feet ❑ meters
d) Attached garage (top of slab)
17.85 ❑x feet .❑ meters
e) Lowest elevation of machinery or equipment servicing the building
N/A x❑ feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
N/A ❑x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG)
N/A ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
N/A feet meters
❑ ❑
structural support
�I 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.
1 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 orimprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No
❑ Check here if attachments.
Certifier's Name License Number
Thomas P. Kiernan 6199
��:`° SIP K/�c,Q'•,� _
Title
Professional Surveyor
; .; S6
S
Company Name
Culpepper & Terpening. Inc.
= •• •
SST 0 •
ufveyo
Address
2980 South 25th Street
City State ZIP Code
Fort Pierce Florida 34981
Signature Date Telephone
Ext.
(772) 464-3537
206
Copy all pages of this Elevation Certificate and all attachments for (1) comm nity official, (2) insurance
agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
J.
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTANT:
In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building
Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
8�17
COBBLESTONE DR.
City
State ZIP Code
Company NAIC Number
FORT
PIERCE Florida 34945
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 El—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
canter 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.
II
2. For Building Diagrams 6-9 with permanent flood openings provided in Section A.Items 8 and/or 9 (see pages 1-2 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.
4. Top of platform of machinery and/or equipment
servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
I5.
� 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
he property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or
Fommunity-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 or Owner's Authorized Representative's Name
ddress City State ZIP Code
I'I Signature Date Telephone
h Comments
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IM10,',ORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Bdilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
8)11,'7 COBBLESTONE DR.
City State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34945
1' SECTION G — COMMUNITY INFORMATION (OPTIONAL)
I'I
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
iued in Items G8—G10. In Puerto Rico only, enter meters.
G ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,
j, 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)
6I or Zone AO.
I
3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes.
I
4. Permit Number
G5. Date Permit Issued
G6. Date Certificate of
i
I.
Compliance/Occupancy Issued
I
II 7. This permit has been issued for: E] New Construction ❑ Substantial Improvement
IG8. Elevation of as -built lowest floor (including basement)
jI of the building: ❑ feet ❑ meters Datum
II 9. BFE feet meters or (in Zone AO) depth of flooding at the building site: ❑ ❑ Datum
IG10. Community's design flood elevation: ❑ feet ❑ meters Datum
IlLocal Official's Name Title
Community Name Telephone
Signature Date
Comments (including type of equipment and location, per C2(e), if applicable)
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6
' BUILDING PHOTOGRAPHS _
OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
017 COBBLESTONE DR.
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34945
fllf
using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
nstructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View'; and, if required, "Right Side View" and
Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or
ents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
Photo One
(Photo One Caption Front Clear Photo One
Photo Two
Photo Two Caption Back Clear Photo Two
kEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
i
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continuation Page
OMB No. 1660-0008
Expiration Date: November 30, 2018
10
ORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
BiUIilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
8,17 COBBLESTONE DR.
Policy Number:
City State ZIP Code
FORT PIERCE Florida 34945
Company NAIC Number
If
'photographs
submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, 'Right Side View" and "Left Side View." When applicable,
must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
i
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Photo Three
Photo Three Caption Right Side ( Clear Photo Three
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Photo Four
Photo Four Caption Left Side Clear Photo Four
II FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6