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Home My WebLink AboutELEVATION CERTIFICATESCANNED t. Lmele county ; PARTMENT OF HOMELAND SECURITY AL EMERGENCY MANAGEMENT AGENCY Flood mm=cc Program ELEVATION CERTIFICATE IMPORTANT: Follow the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION Building Owner's Name MR. & MR.S LASH ling Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or PO. Route and Box No. 40 NETTLES BOULEVARD City JENSEN BEACH State FL A3',fProperty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) i LOT 40, NETTLES ISLAND SECTION 2 A7; A8. a OMB No. 1660-0008 ` Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: ZIP Code s4.57 Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Kt51UtN 1 IAL Latitude/Longitude: Lat. 27"17'08" Long. 80°13'37" Horizontal Datum: Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. Building Diagram Number 1 R NAD 1927 ❑x NAD 1983 For a building with a crawlspace or enclosure(s): • N/A A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage 211 sq ft b) Number of permanent flood openings in the crawlspace N/A b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ®No d) Engineered flood openings? ❑ Yes ®No H SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. FIP Community Name & Community Number B2. County Name B3. State UNINCORP / 120285 ST. LUCIE I FL B4. ap/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 2111 C 0311 J 02/16/2012 02/16/2012 AE 6.0 B10'dlllndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: FlS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11 Indicate elevation datum used for BFE in Item 69: rj NGVD 1929 ® NAVD 1988 f7 Other/Source: B12 Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? F.-) Yes ® No Resignation Date: / / ❑ CBRS . C OPA 1�1 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Jouilding elevations are based on: ❑ Construction Drawings* ® Building Under Construction* ❑ Finished Construction II 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 �2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. enchmark Utilized: 94 77 AO4 FLDT Vertical Datum: NAVD 1988 I dicate elevation datum used for the elevations in items a) through h) below. n NGVD 1929 ® NAVD 1988 Fl 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) 6. 0 ® feet ❑ meters l) Top of the next higher floor N/A ; ❑ feet ❑ meters Bottom of the lowest horizontal structural member (V Zones only) N/A . LJ feet ❑ meters Attached garage (top of slab) 4 . 85 ® feet ❑ meters I I" Lowest elevation of machinery or equipment servicing the building N/A . L] feet ❑ meters (Describe type of equipment and location in Comments) flit f Lowest adjacent (finished) grade next to building (LAG) 3 . 5 ® feet ❑ meters Highest adjacent (finished) grade next to building (HAG) 4 . 7 ® feet ❑ meters Lowest adjacent grade at lowest elevation of deck or stairs, including N/A . LJ feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITj=CT CERTIFICATION This certification inform' is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation !on. I certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. i _ Chec here if comments are provided on back of form. Were latitude and longitude in Section A provided by a "Che lik here if attachments. licensed land.surveyorl L Yes LJ No Name License Number RACE - f R. STARKEY 004459 SEAL J Com any Name HERE---. - D SURVEYOR A, URIGHT LAND SURVEYING, INC. - _ Certifierl's EARLE Tice III PROF 150 I Cl ty State ZIP Code R AVENUE, UNIT 419 STUART FL 34994 Date Telephone p� 01/12/2016 772 286-7694 086-0-33 (Revised 7/12) See reverse side for continuation. Replaces all previous editions. Signatu, FEMA Fdtm .! C. ELEVATION CERTIFICATE, page 2 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 PO. Route and Box No. Policy Number: 40 NETTLES BOULEVARD City State ZIP Code Company NAIL Number: JENSEN BEACH Fl- 34994 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Signaye �.� Date 01/12/2016 SUCTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones 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, Band C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter 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, crawispace, or enclosure) is [--feet [-1 meters ❑ above or [_-]below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet F1 meters R above or n below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters [-1 above or R below the HAG: E3. Attached garage (top of slab) is LI feet R meters n above or n below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ 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 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 The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMAissued or community -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 Address City State ZIP Code Signature Date Telephone Comments Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) 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 used in Items G8-G10. In Puerto Rico only, enter meters. G1. 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. 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. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: .] feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: J feet ❑ meters Datum G10. Community's design flood elevation: C feet ❑ meters Datum Local Official's fame Title Community, Name •.,, Telephone Signature'_.-' , Date Comments' Check here if attachments. FEMA Form 086-0-33 (Revised 7/12) Replaces all previous editions.