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HomeMy WebLinkAboutELEVATION CERTIFICATE 9-18-18U. DEPARTMENT OF HOMELARZ� �ECURITY WANWE® ~ ' OMB No. 1660-0008
Feceral Emergency Management Agency �� Expiration Date: November 30, 2018
Nat i' naI Flood Insurance Program s LAB 9 �� a ny
ELEVATIO� Ct�TIFICATE
Important: Follow the instructions on pages 1-9.
Cory all Daqes of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
ur -
III SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Building Owner's Name
Policy Number:
1'1.
1ADE & ELIZABETH O'NEY
u
4I60
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
WATERSONG WAY
Company NAIC Number:
City State ZIP Code
FORT PIERCE Florida 34949
3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
,'ARCEL ID 2532-500-0060-000-3 LOT 46 WATERSON PUD PLAT NO. 1
4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A15.
Latitude/Longitude: Lat. N 27 23 26.07 Long. W -80 15 37.77 Horizontal Datum: ❑ NAD 1927 0 NAD 1983
Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
I6.
Building Diagram Number 6
AV.
8. For a building with a crawlspace 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 Z No
9. For a building with an attached garage:
a) Square footage of attached garage 0.00 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
1. NFIP Community Name & Community Number
B2. County Name
B3. State
AINT LUCIE COUNTY, UNINCORPORATED 120285
SAINT LUCIE
Florida
B
. 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
1
111 C 0194
J
02-16-2012
02-16-2012 ,
AE
6
10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
❑ FIS Profile ❑X FIRM ❑ Community Determined ❑ Other/Source:
11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source:
12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Z Yes ❑ No
Designation Date: 10-01-1983 0 CBRS ❑ OPA
F TA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
i
E E IATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
III
IM
„ORTANT: 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:
48 0 0 WATERSONG WAY
Ci� State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34949
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
�11. Building elevations are based on: ❑ Construction Drawings* ❑X Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
Elevations - 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.
Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Benchmark Utilized: ST LUCIE COUNTY BM "B-308" Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 0 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) 8.0 feet ❑ meters
b) Top of the next higher floor N/A 0 feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A feet ❑ meters
d) Attached garage (top of slab) 6.0 N feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building N/A Z feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 5.0 0 feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 5.5 0 feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A © feet ❑ meters
structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
I
is certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
-ertify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false
may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Ifatement
Were latitude and longitude in Section A provided by a licensed land surveyor? Z Yes ❑ No ❑ Check here if attachments.
e rtifier's Name License Number
iIHA RLES ARNOLD, PSM FLORIDA LS #4971
"
C
= -
V�tle
ICE PRESIDENT
ompany Name
P)RNOLD
SURVEYING, INC.
:J
'
Address
�888 N KINGS HIGHWAY #425
II
1
'ity, State ZIP Code
TORT PIERCE Florida 34951
ignature Date Telephone Ext.
09-16-2018 (772) 708-1819
Oiopy
all pages of this *evatio6 Cerfificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
comments (including type of equipment and location, per C2(e), if applicable)
P;�RT
OBTAINED USING HANDHELD DEVICE; B9 LOT HAS SEVERAL ZONES BUT HOUSE LIES SOLELY IN ZONE AE-6; C2 ELEV
IS FOR FORMBOARDS ONLY; C2A REFERS TO FLEX SPACE SEPARATED BY WALL FROM GARAGE MEANING GARAGE
I
1
ATTACHED; C213 REFERS TO GARAGE SEPARATED BY WALL FROM FLEX SPACE MEANING GARAGE IS ATTACHED; PGS
1 2 & 5 COMPLETED BY SURVEYOR; PGS 3,4 & 6 LEFT BLANK INTENTIONALLY & IS NOT CERTIFIED BY SURVEYOR
FE IA Form 086-0-33 (7/15) Replaces all previous editions. roan rage 2- of 6
i
E i EVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
III
I 'PORTANT:
In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
wilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
4.60
WATERSONG WAY
9ity
State ZIP Code
Company NAIC Number
11
F
RT PIERCE Florida 34949
SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A (WITHOUT BFE)
F
u r Zones AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
c
6
mplete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
e
ter meters.
E
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.
E
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.
E
Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E
i . Top of platform of machinery and/or equipment
servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E
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 ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
I! SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
T
'e property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or
c
l munity-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
P
perry Owner or Owners Authorized Representative's Name
11il
A
dress City State ZIP Code
Signature
Date Telephone
C
mments
I
i
❑ Check here if attachments.
FEIA Form 086-0-33 (7/15) Replaces all previous editions. corm rage 3 or o
iEVATION
CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
III
IO PORTANT: 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:
11
860 WATERSONG WAY
pity State ZIP Code
Company NAIC Number
IIbRT PIERCE Florida 34949
I� SECTION G — COMMUNITY INFORMATION (OPTIONAL)
,Ihe local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
ections 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.
i
❑ 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.)
12 ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE)
or Zone AO.
i3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes.
d4.
Permit Number
G5. Date Permit Issued
G6. Date Certificate of
Compliance/Occupancy Issued
A
G�k . This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) E] feet ❑meters Datum
II of the building:
G BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G 0. Community's design flood elevation: ❑feet ❑meters Datum
L
°hal Official's Name Title
f
I
C
"mmunity Name Telephone
I'
Si
nature Date
C
� mments (including type of equipment and location, per C2(e), if applicable)
i
I
V
ll
I
f
f
❑ Check here if attachments.
I
FEI A Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6
it
II
LEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See Instructions for Item A6.
OMB No. 1660-0008
Expiration Date: November 30, 2018
1 ,', PORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
uilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
J860WATERSONG WAY
Qity State ZIP Code
Company NAIC Number
1ORT PIERCE Florida 34949
If
using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructions
for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View'; and, if required, "Right Side View" and
'Left
Iyents,
Side 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.
V
V
ON
D
V
h
Photo One
P
'oto One Caption FRONT VIEW -PHOTO TAKEN SEPTEMBER 15, 2018 ClearP,hoto One
I
V'
f
{
I '
THIS SECTION LEFT BLANK
I
V'
Photo Two
Ph
'to Two Caption Clear Photo
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
�ILEVATION
CERTIFICATE
BUILDING PHOTOGRAPHS
Continuation Page
OMB No. 1660-0008
Expiration Date: November 30, 2018
III
1 ,' PORTANT: 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:
1860 WATERSONG WAY
, ity State ZIP Code
Company NAIC Number
TORT PIERCE Florida 34949
��If
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,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
I
I
THIS SECTION LEFT BLANK
I
` Photo Three
roto Three Caption
Clear Photo Three
I
I
THIS SECTION LEFT BLANK
Photo Four
P,i
oto Four Caption ��,Glear Photo'Four
F U'MA Form 086-0-33 (7/15) Replaces all previous editions. rorm rage o or 0