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Home My WebLink AboutELEVATION -CERTIFICATEa. DL`4'ARTMENT OF HOMELAND SECURITY y �' ' }' V A 1 10_ N G t R 111- I.GA 1 t �- OMB No. 1660-0008 FED)i AL :MbRGENCY National Floi MANAGEMENT AGENCYi d Insurance Program Imp , Int: Read the instructions on pages 1-y. " Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION -FOR INSURANCE-CQ11tIPANY USE, Al. Buildi i'g Owner's Name LASH Policy Nurtitier, " A2. Buildi Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. -Company NAIC.Ntfrftber; 40 NETTLIE S BLVD. City JENSEN BEACH State FL ZIP Code 34957 qr.ANWfpn A3. Prope',y Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) U LOT 40, NETTLES ISLAND PROJECT SECTION 2 _ A4. Building »e !_ ul ," o co, un1 Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitu /Longitude: Lat. 27°17'08" N Long.-80°13'37" W Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach l t least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1B A8. For a t;itilding with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 208 sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade 2 nvn r1 Tn+nI ne+- nfflnnrl nnoninne in AQ h Ann cn in d I ineered flood openings? ❑ Yes 0 No d) Engineered flood openings? 0 Yes El No !III SECTION B -FLOOD INSURANCE RATE MAP (FIRM)- INFORMATION B1. NFIP Community Name & Community Number B2. County Name JB3. State UNINCORP�'120285 ST. LUCIE FL B4. Map/P�i nel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 1211 0311 J 02/16/2012 Effective/Revised Date Zone(s) AO, use base flood depth) li 02/16/2012 AE 6.0 1310. Indica4 the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ 'FIS Profile 0 FIRM El Community Determined ElOther/Source: _ B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: B12. Is the bl'I ilding located in a Coastal Barrier Resources System �BRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date: _ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building )elevations are.based on: ❑ Construction Drawings* ❑ Building Under Construction* 0 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, 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. Benchm Irk Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 88 Indicate,�levation datum used for the elevations in items a) through h) below. [I NGVD 1929 X❑ NAVD 1988 ElOther/Source: Datum rued for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top oi'bottom floor (including basement, crawlspace, or enclosure floor) 6.0 0 feet ❑ meters b) T . ,1 he next higher floor 15.4 0 feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA._ ❑ feet ❑ meters d) Attached garage (top of slab) 4.85 0 feet ❑ meters e) Lowes I elevation of machinery or equipment servicing the building 6.0 0 feet ❑ meters (Desci� a type of equipment and location in Comments) f) Lowes , adjacent (finished) grade next to building (LAG) 4.0 0 feet ❑ meters g) Highe- adjacent (finished) grade next to building (HAG) 4.7 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support .N/A._ ❑ feet ❑ meters II ; SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifica ion is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information, 11certify that the information on this Certificate represents my best efforts to interpret the data available. 1 320-73-01-FINAL I understand) at any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 0 Check MeI're if attachments. licensed land surveyor? 0 Yes El No ACE SEAL Certifier's Name EARLE R. STARKEY License Number 004459 I Title PROFESSIONAL LAND SURVEYOR Company Name ACCURIGHT LAND SURVEYING INC. 15Qi1 DECK Cit TUART State FL ZIP Code 34994 06 PLS #44v9 Sig TA Date 06/24/2016 Telephone 772-286-7694 u FEMA F6rmd86-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. �ELEVAT!14 CERTIFICATE, page 2 r . IMPORTANT: In these spaces, copy the cony ` onding information from Section A. t FOR INSURANCE COMPANY USA Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 40 NETTLES BLVD. City JENSEI BEACH State FL ZIP Code 34957 Company:NAiC Number. SECTION D-SURVEYOR, ENGINEER, ORARCHITECT CERTIFICATION (CONTINUED) Copy both 41iles of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments 11,�9-D SMART VENT MODEL #1540-520 C2-E A/C STAND Date 06/24/2016 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones 0 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; ems El-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Prbvi • I'I elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent gradei HAG) and the lowest adjacent grade (LAG). a) ToR of bottom floor (including basement, crawlspace, or enclosure) is — _ Elfeet ❑ meters ❑ above or El below the HAG. b) Topll of bottom floor (including basement, crawlspace, or enclosure) is _._ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ El feet El meters Elabove or below the HAG. E3. Attached garage (top of slab) is ❑ feet El meters ❑ above or ❑ below the HAG. E4. Top 6 platform of machinery and/or equipment servicing the building is _._ El feet El meters El above or ❑ below the HAG. CG 7...,e�' n —1— li n.. il-4 ,4c 01 nnmhor k nuniinhiP is the Mn of tha hottom floor elevated in accordance with the community's floodplain management ordin' Iice? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. . SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The propert' or Zone AO;1 owner or owners authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) ust sign here. The statements in Sections A, B, and E are correct to the best of my -knowledge. Property O '� ers or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local offic1' of this Elevati G1. ❑ Th �' is authorized G2. ❑ A cmmunity G3. ❑ The ll,1l I 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 n Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. following information (Items G4—GI0) is provided for community floodplain management purposes. [EZ7Fermit Dumber G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This pe,� G8. Elevatio G9. BFE or I G10. Commuiity's it has been issued for: ❑ New Construction ❑ Substantial Improvement of as -built lowest floor (including basement) of the building: _ _ ❑feet - ❑ meters Datum in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters Datum design flood elevation: __ ❑ feet ❑ meters Datum Local OfficiI's Name Title Community' ame Telephone Signature •.,li Date Comments ❑ Check here if attachments. 0. OgraP. 40 NETTLES BLVD, Safe:: ZIP Ci3dO. JENSEN BEACH FLORIDA 34957 if"-s"!n-, Ef v" ' d.ateo"toobtain 'NF-IP fo'flnsUr6h, affix a feast -buudiog;otopgraphs" OOowgcordhq.' tha h Etta far' 16emA.dimfi All phdtb9 with data tMe'h,Trot`VteW:andRearV-andUired,,13ight'. .. - "Left Sidd:View" submitting'mor,OhbtogriaOh thIUdWihit pegs, geuseih dbMnuati oPage f II0.: FRONT REAR 06/24/2016 17 11-240 SIDE 06/24/2016 9/16/2015 Florida Florida Building Code Online c � ii �, • � ' e • Q _ BCIS Home Log In User Registration Hot Topics Submit surcharge Stats & Facts Publications FBC Staff' BCIS Site Map I Links Search Product Approval USER: Public User ' Product Approval Menu > Product or Application Search > Application List > Application Detail FL # FL5822-R3 Application Type Revision Code Version • 2014 Application Status Approved Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Smart Vent Products, Inc. 430 Andbro Dr Unit 1 Pitman, NJ 08071 (877)441-8368 info@smartvent.com Michael Graham info@smartvent.com Michael J. Graham 20 Warrick Ave. Glassboro, NJ, NJ 08028 (888)628-4115 mike@smartvent.com Category Structural Components Subcategory Products Introduced as a Result of New Technology Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer ✓i Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed the Hermes F. Norero P.E. Evaluation Report Florida License PE-73778 Quality Assurance Entity Architectural Testing, Inc. Quality Assurance Contract Expiration Date 12/31/2015 Validated By Locke Bowden ,,. Validation Checklist- Hardcopy Received Certificate of Independence FL5822 R3 COI Smart Vent COI SS 2015-02-23.odf Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Sections from the Code 1612.5(1)(1.2) 1709.2 �w.floridabuilding.org/pr/pr_app_ d.aspx?param=wGEVXQwtDgvMdF6zR4iHLm1meckcmccEhW3h4VZDdFY%3d 1/3 9/16/26 11 Florida Building Code Online t Product Approval Method Method 2 Option B Date Submitted 02/26/2015 Date Validated 02/27/2015 Date Pending FBC Approval 03/03/2015 Date Approved 04/15/2015 Summary of Products FL # i Model, Number or Name Description 15822.1 I Model #1540-510 I SmartVent J Limits of Use Approved for use in HVHZ: Yes Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: +100/-100 Other: One vent may be used for up to 200 sq. ft. of interior space (minimum 2). Installation Instructions PTID 5822 I Installation Instructions.odf Verified By: Hermes F. Norero, P.E. Florida P.E. 73778 Created by Independent Third Party: Yes Evaluation Reports FL5822 R3 AE PER3229 SS 2015-02-23.odf FL5822 R3 AE SmartVent - Impact Requirements Letter SS 2015-02-26.pdf Created by Independent Third Party: Yes 5822.2 Model #1540-514 SmartVent Overhead Door Model Limits of Use Installation Instructions Approved for use in HVHZ: Yes FL5822 R3 II Installation Instructions.odf Approved for use outside HVHZ: Yes Verified By: Hermes F. Norero, P.E. Florida P.E. 73778 Impact Resistant: N/A Created by Independent Third Party: Yes Design Pressure: +100/-100 Evaluation Reports Other: One vent may be used for up to 200 sq. ft. of interior FL5822 R3 AE PER3229 SS 2015-02-23.pdf space (minimum 2). FL5822 R3 AE SmartVent - Impact Reauirements Letter SS 2015-02-26.pdf Created by Independent Third Party: Yes 5822.3 Model #1540-520 FloodVent Limits of Use Approved for use in HVHZ: Yes Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: +100/-100 Other: One vent may be used for up to 200 sq. ft. of interior space (minimum 2). Installation Instructions FL5822 R3 II Installation Instructions.odf Verified By: Hermes F. Norero, P.E. Florida P.E. 73778 Created by Independent Third Party: Yes Evaluation Reports FL5822 R3 AE PER3229 SS 2015-02-23.odf FL5822 R3 AE SmartVent - Impact Requirements Letter SS 2015-02-26. odf Created by Independent Third Party: Yes 5822.4 Model #1540-524 FloodVent Overhead Door Model Limits of Use Approved for use in HVHZ: Yes Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: +300/-500 Other: One vent may be used for up to 200 sq. ft. of interior space (minimum 2). Installation Instructions FL5822 R3 II Installation Instructions.i3df Verified By: Hermes F. Norero, P.E. Florida P.E. 73778 Created by Independent Third Party: Yes Evaluation Reports FL5822 R3 AE PER3229 SS 2015-02-23.pdf FL5822 R3 AE SmartVent - Impact Requirements Letter SS 2015-02-26.odf Created by Independent Third Party: Yes 15822.5 Model #1540-570 Wood Wall FloodVent Limits of Use Approved for use in HVHZ: Yes Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: +100/-100 Other: One vent may be used for up to 200 sq. ft. of interior space (minimum 2). Installation Instructions FL5822 R3 II Installation Instructions.odf Verified By: Hermes F. Norero, P.E. Florida P.E. 73778 Created by Independent Third Party: Yes Evaluation Reports FL5822 R3 AE PER3229 SS 2015-02-23.13df FL5822 R3 AE SmartVent - Impact Requirements Letter SS 2015-02-26.odf ' Created by Independent Third Party: Yes 15622.6 1 Model #1540-574 I Wood Wall FloodVent Overhead Door Model Limits of Use Approved for use in HVHZ: Yes Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: +300/-300 Other: One vent may be used for up to 200 sq. ft, of interior space (minimum 2). Installation Instructions FL5822 R3 II Installation Instructions.pdf Verified By: Hermes F. Norero, P.E. Florida P.E. 73778 Created by Independent Third Party:, Yes Evaluation Reports FL5822 R3 AE PER3229 SS 2015-02-23.odf FL5822 R3 AE SmartVent - Impact Requirements Letter SS .floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEV XQwtDgvMdF6zR4iHLm lmeckcmccEhW3h4VZDdFY%3d 2/3