HomeMy WebLinkAboutELEVATION CERTIFICATEr
U.S. DEPARTMENT OF HOMELAND SECURITY SCANNF-®
Federal[ Emergency Management Agency 13Y
Nation Flood Insurance Program �o ���� CoonW
ELEVATION CERTIFICATE
j Important: Follow the instructions on pages 1-9.
OMB No. 1660-0008'
Expiration Date: November 30, 2018
all oases 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
7/yA1. Building Owner's Name
Policy Number.
D.R. Horton, Inc.
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
8709 Cobblestone Drive
City State ZIP Code
Fort Pierce Florida 34945
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
2326-600-0043-000-2, Lot 38
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 27°24'35.87" N. Long.80°24'53.09" 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 crawispace.or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in. A8.b 0.00 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 0
c) Total net area of flood openings in A9.b 0.00 sq in
d) Engineered flood, openings? ❑ Yes x❑ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2..County Name
St. Lucie County, 120285 1 St. Lucie
B4. Map/Panel I B5. Suffix I B6. FIRM Index
Number Date
12111CO170 1.J 102-16-2012
B7. FIRM Panel B8. Flood
Effective/ Zone(s)
Revised Date
02-16-2012 AE
B10. Indicate the source of the Base Flood Elevation (BFE) data or base
❑ FIS Profile. ❑x FIRM ❑ Community Determined ❑ Other/Si
B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area o
Designation Date: ❑ CBRS ❑ OPA
'X
AA
FEMA Form 086-0-33 (7/15) Replaces all previous editions.
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� 1
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTA OT: 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:
8709 Cob 'lestone Drive
9
City 'l State ZIP Code
Company NAIC Number
Fort Pier I Florida 34945
lil SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
IIU
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x Finished Construction
*A r�lew Elevation Certificate will be required when construction of the building is complete.
C2. Ele I ations —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.
Co i plete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Be chmark Utilized: AF6653 Vertical Datum: NAVD 88
Ind cate elevation datum used for the elevations in items a) through h) below.
11I ❑ NGVD 1929 Fx� NAVD 1988 ❑ Other/Source:
Daum 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) 18.60 ❑x feet ❑ meters
b) Top of the next higher floor N/A ❑ feet ❑ meters
N/A feet meters
c) IBottom of the lowest horizontal structural member (V Zones only) ❑ ❑
d) ,Attached garage (top of slab) 17.93 ❑x feet ❑ meters
e) '!Lowest elevation of machinery or equipment servicing the building 17.99 0 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 17AO ❑x feet ❑ meters
g)I'I Highest adjacent (finished) grade next to building (HAG) 17.80 x❑ feet ❑meters
h) I Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ❑feet ❑'meters
structural support
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This c 'lrtification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
l certi ' that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
state II"ent may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? Z Yes ❑ No ❑ Check here if attachments.
Certifi" is Name License Number
Thom's P. Kiernan 6199
ii
Title 'A
Profe ,sional Surveyor
Com Name
,any
Culp pper & Terpening. Inc.
T
Addr "ss
2980'South 25th Street
City State ZIP Code
Fort fierce Florida 34981
Sign ture Date Telephone Ext.
3 l:� f / 464-3537 206
(772)
I
Cop Jall pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Co ments (including type of equipment and location, per C2(e), if applicable)
Equi i ment in C2(e) refers to Concrete A/C pad on rear of structure.
i
it
FEM Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6
�I
LEVAT N CERTIFICATE
E O
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 Steet
Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
8709 Cobblestone
Drive
City
State ZIP Code
Company NAIC Number
Fort Pierce'
j� Florida 34945
SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones i0 and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete S "ctions A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter mete .
E1. Provid elevation information for the following and check the appropriate boxes to show whether the elevation is above or below
the higest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Tor of bottom floor (including basement,
cra [space, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Tor of bottom floor (including basement,
crai'I Ispace, or enclosure) is El feet El meters El above or El below the LAG.
E2. For Bu Iding Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions),
the ne higher floor (elevation C2.b in
the diarams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
i
E3. Attach I�i garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of latform of machinery and/or equipment
servici ig the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone 40, only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodpl lin 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 propert
community-
owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or
J sued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Ov
rner or Owner's Authorized Representative's Name
Address
City State ZIP Code
Signature
Date Telephone
Comments
�f
I
i
,I-
❑ Check here if attachments.
FEMA Form 86-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
ELEVAT SON 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 St eet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
8709 Cobb estone Drive
i
City
State ZIP Code
Company NAIC Number
Fort Pierce
Florida 34945
SECTION G — COMMUNITY INFORMATION (OPTIONAL)
The local o I icial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sections A iB, C (or E), and G of this Elevation Certificate. Complete the applicable item(s).and sign below. Check the measurement
used in It s G8—G10. In Puerto Rico only, enter meters.
G1. ❑ TII a information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,
e ineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation
d ata in the Comments area below.)
G2 ❑ ��community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE)
o'I Zone AO.
G3. ❑ e following information (Items G4—G10) is provided for community floodplain management purposes.
I
G4. Permit
G5. Date Permit Issued
G6. Date Certificate of
IICompliance/Occupancy
Issued
G7. This permit
has been issued for: ❑ New Construction ❑ Substantial Improvement
t
G8. Eleva
of the
jouilding: n of as -built lowest floor (including basement)
❑feet ❑meters Datum
I
G9. BFE o
(in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. Com
I'unity's design flood elevation: ❑ feet ❑ meters Datum
Local Offici
'I's Name Title
I
Community
Name Telephone
Signature
Date
I
Comments
('including type of equipment and location, per C2(e), if applicable)
I
I
a
i
❑ Check here if attachments.
FEMA Form 86-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6
1
ELEVAT ON CERTIFICATE
BUILDING PHOTOGRAPHS OMB No.1.660-000s
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 St
et Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
8709 Cobb
estone Drive
City
State ZIP Code
Company. NAIC Number
Fort Pierce,i
Florida 34945
If using tie
I
Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructio
's for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and
"Left Sid
lView." When applicable, photographs must show the foundation with representative examples of the flood openings or
vents, as
it dicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
'.
f'ys,. S �--
- Photo One
Photo One (Caption Front 3/6/19 C(ear,Photo One°
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k
Photo Two
Photo Tw qI Caption Rear 3/6/19 Clear Phoff,TW6'.
FEMA Fo 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
i
I
ELEVATION
BUILDING PHOTOGRAPHS OMB No. 1660-0008
CERTIFICATE Continuation Page Expiration Date: November 30, 2018
IMPORTAOT',
: 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:
8709 Cobb
estone Drive
City
State ZIP Code Company NAIC Number
Fort Pierce
Florida 34945
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: dat l 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 vents, as indicated in Section A8.
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FEMA Form 86-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6
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