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HomeMy WebLinkAboutELEVATION CERTIFICATE 11-26-18U.�). 'LEPARTMENT OF HOMELAND SEIo.'_,`]TYSC ACNE© OMB No. 1660-0008 Feder�'� I Emergency Management Agency �� Expiration Date: November 30, 2018 Nation l Flood Insurance Program 91e Lucie Cou* 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. 1 SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: D.R.IHORTON INC. A2. Puilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: ox No. 871 COBBLESTONE DR. i ��� ity State ZIP,Code TORT PIERCE Florida 34945 A3. ri roperty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 2326J 11600-0044-000-9 LOT 39 A4. Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Lat. 27°24'35.95" N. Long. 80°24'53.82" W. Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 I�uilding latitude/Longitude: A6. ttach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. uilding Diagram Number 1A A8. for a building with a crawlspace or enclosure(s): 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 1 Engineered flood openings? ❑ Yes ❑x No A9. F r a building with an attached garage: i aSquare 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 i c , Total net area of flood openings in A9.b' N/A sq in I d ' Engineered flood openings? ❑ Yes ❑x No i I, SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State St. Lullie County 120285 Saint Lucie Florida B4. Ma1°/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Nu ber Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12111 QI0170 I' J 02-16-2012 02-16-2012 AE 16.5 B10. icate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: kFIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. 1idicate datum for BFE in Item 139: NGVD 1929 NAVD 1988 Other/Source: elevation used ❑ x❑ ❑ B12. I the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No I,esignation Date: ❑ CBRS ❑ OPA FEMA F11 orm 086-0-33 (7115) Replaces all previous editions. Form Page 1 of 6 i y _ ELEV,, TION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPOR ,ANT: 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: 8713 C BBLESTONE DR. City �1 State ZIP Code Company NAIC Number FORT PIERCE Florida 34945 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. E�Uilding elevations are based on: ❑ Construction Drawings* 0 Building Under Construction* ❑ Finished Construction * A new Elevation Certificate will be required when construction of the building is complete. C2. E Ilevations — 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. omplete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. I nchmark Utilized: AF6653 Vertical Datum: NAVD 88 1 dicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: atum used for building elevations must be the same as that used for the BFE. Check the measurement used. Top of bottom floor (including basement, crawlspace, or enclosure floor) 18.53 ❑x feet ❑ meters 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) 17.93 ❑ feet ❑ meters Lowest elevation of machinery or equipment servicing the building N/A 0 feet ❑meters (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) N/A ❑x feet ❑ meters E) Highest adjacent (finished) grade next to building (HAG) N/A 0 feet ❑ meters Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ feet ❑ meters j structural support N/A �I SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This a rtification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. „ l cer h that the infom�ation on this Certificate represents my best efforts to interpret the data available. I understand that any false state e may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Werelatitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certif er's Name License Number Tho Ias P. Kiernan 6199 ••• '�P`S . • . FAQ 11 •• O ;;�wNu '• '� .•_ S� * :. ` Title Professional Surveyor Comt, any Name Culppper & Terpening. Inc.` ;. cam, .. a OF `� Addr "ss 2980I`ISouth 25th Street C •••'��Q�/Sup eyc�a;���• City II,I State ZIP Code Fort Rierce Florida 34981 Sign °ture Date Telephone Ext. 464-3537 206 (772) Copy "all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Com i ents (including type of equipment and location, per C2(e), if applicable) FEMA �orm 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 J ELEV „ TION CERTIFICATE -'1 OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildin Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8713 C BBLESTONE DR. i City State ZIP Code Company NAIC Number FORT FIERCE Florida 34945 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zoi es 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. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter E1. Pr eters. (vide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below th ° highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) i 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. Folr Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), thII3 next higher floor (elevation C2.b in th diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. At ICI ched garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. To s of platform of machinery. and/or equipment fvicing the building is E] feet E] meters E] 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 fl it dplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. h SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The pr,, perty owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or comm inity-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Prope 'y Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signatl' re Date Telephone Comm"ants I li ❑ Check here if attachments. FEMA orm 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVITION 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 Buildingl Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8713 COBBLESTONE DR. i City li State ZIP Code Company NAIC Number FORT PIERCE Florida 34945 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The loal 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 Items G8—G10. In Puerto Rico only, enter meters. G1. jj� 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. I 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 G7. T is permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. E evation of as -built lowest floor (including basement) ❑ feet ❑ meters o the building: Datum G9. Eli E or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. community's feet meters design flood elevation: ❑ ❑ Datum Local fficial's Name Title li CommDnity Name Telephone Signature i Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA �jorm 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEV,,, TION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6 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 8713 Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. C1PBBLESTONE DR. Policy Number: City FORT 11 State ZIP Code PIERCE Florida 34945 Company NAIC Number If usinlg instruc',tions "Left vents, the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View'; and, if required, "Right Side View" and ide View." When applicable, photographs must show the foundation with representative examples of the flood openings or 'as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. Photo One Photo ne Caption Front " Clear Photo One Photo Two Photo wo Caption Back `Clear Photo Two FEMA corm 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE _,BUILDING PHOTOGRAPHS Continuation Page ' OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORtANT: In these spaces, copy the corresponding information from Section A: FOR INSURANCE COMPANY USE Buildin 8713 COBBLESTONE ��IStreet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. DR. Policy Number: City FORT State ZIP Code ;IERCE Florida 34945 Company NAIC Number If subr with: photo I iitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs i ate taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and "Left Side View." When applicable, raphs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. I II I I Photo Three Photo t hree Caption Right Side rClear Photo Three I i I Photo Four Photo 'Four Caption Left Side } Clear Photo Four FEMA corm 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6