Loading...
HomeMy WebLinkAboutELEVATION CERTIFICATE5F� TMEI T OF HOMELAND SECURITY o-- I I - 0 N CER I iFr A I t wEL..5f ! ZMERGENCY MANAGEMENT AGENCY " _5 OMB No. 1660-0008 National FloodlAwanceProgram Important: Read the instructions on 'pages 1-9. Expiration Date: July,31, 2015 II SECTION A - PROPERTY INFORMATION_ ........,..W IN .... A2. Building �4, treet Address (including Apt., Unit, Suite, and/o Bldg. No.) or P.O. Route and 13oz41ioiU% /it 886 NETTLES BLVD. raw City JEf lip BEACH State FL ZIP10 957 , IIII aa�l�.� C� uTI A3. Property Description (Lot and Block Numbers, Tax Parce Number, Legal Description, etc.) LOT 886, NETITLES ISLAND PROJECT SECTION 2 A4. Building III se (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/I ongitude: Lat 27°17'06.3" N Long. 80*13'17.3�' W Horizontal Datum: ❑ NAD 1927 © NAD 1983 A6. Attach a least 2 photographs of the building if the Certifi to is being used to obtain flood insurance. A7. Building ( iagram Number 5 A8. For a bu ding with a crawlspace, orenclosure(s): A9. For a building with an attached garage: a) Squ�6 footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage NIA sq ft b) Number of permanent flood openings in the crawlspa b) Number of permanent flood openings in the attached garage C r eJ`closure(s) within 1.0 foot above adjacent grade NIA within 1.0 foot above adjacent grade NIA c) lnet area of flood openings- in A8.b N/A sq in c) Total net area of flood openings in A9.b NIA sq in d) Engi eered flood openings? Yes © No d) Engineered flood openings? ❑Yes ©No 11 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP C4munity Name & Community Number I I B2. County Name I B3. State UNINCORP 120285 ST. LUCIE FL B4. Map/Panel Number B5. Suffix B6. FIRM Inde Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111 0311 J 02/16/20112 Effective/Revised Date 1 Zone(s) AO, use base flood depth) 1 III 02/16/2012 AE 6.0 B10. Indicatdlthe source of the Base Flood Elevation (BFE) data or base Tiooa aepm emerea in item ntp. ❑ IS Profile - N FIRM ❑ Community etermined ❑ Other/Source: _ 611. Indicat i elevation datum used for BFE in Item B9: ❑ GVD 1929 NAVD 1988 ❑Other/Source: B12. Is the b ilding located in a Coastal Barrier Resources S lystem ffRS) area or Otherwise Protected Area (OPA)? ❑ Yes © No Designation Date: _ I CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building Ile, levations are based on: ❑ Constructio Drawings* ❑ Building Under Construction* ❑X Finished Construction *A new elevation Certificate will be required when const ction of the building is complete. C2. Elevations - Zones Al-A30, AE, AH, A (withBFE), VE, 1 V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below adcording to the building diagram specified in Ite AT In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. [INGVD 1929 © NAVD 1988 ❑ Other/Source: _ Datum 'bed for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top bottom floor (including basement, crawlspace, r enclosure floor) 8.2 X❑ feet ❑ meters b) Top dN the next higher floor N/A _ ❑ feet El meters C) Botto of the lowest horizontal structural member (V - ones only) NIA_ ❑ feet ❑ meters I d) Atta ed garage (top of slab) N/A., ❑ feet El meters II e) Low�st elevation of machinery or equipment servicing in Comment the building 7.1 © feet El meters (Describe type of equipment and location f) LowJs1 t adjacent (finished) grade next to building (LAG) s) 4.5 N feet ❑ meters g) Highest adjacent (finished) grade next to building (HAIG) 4.7 ©feet meters ❑ ❑ h) Lowelllllllst adjacent grade at lowest elevation of deck or IIII tairs, including structural support NIA._ feet meters SECTION D - SURV YOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifi�tion is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation informatio I certify that the information on this Certificate represents my best efforts to interpret the data available. 2237-01-01 I understand that any false statement maybe punishable•b fine orimprisonment under 18 U.S. Code, Section 1001. © Che here if comments are provided on back of form Were latitude and longitude in Section A provided by a • Chec here if attachments. licensed land surveyor? ❑X Yes ❑ No ,LACE SF Certifier's ame EARLE R. STARKEY License Number 004459 Title PROCESSIONAL LAND SURVEYOR Com N�me ACCURIGHT LAND SURVEYING INC. 12015 PILS #4459 PLS #4459 Addr DECKER AVENUE #4 ity STUART State FL ZIP Code 34994 Signa u-n LE R. Date Telephone 772-286-7694 FEMA Fo086-0-33 (7/12) I See reverse side Tor continuation. Kepiaces au prevIUus euuwi w. ELEV, IMPORTANT: In these spaces, copy tb: from Section A. <. f Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 886 NETTLES BLVD. City JENSEN BEACH State FL ZIP Code 34957 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 C2-E A/C PEDASTAL Signature EARLE R. S Y Date 05/29/2015 II SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) I� For Zones AO and A (without BFE), complete Items. El-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E7-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) Too of bottom floor (includina basementcrawlsnace_ nr enclnsurel is ❑facet ❑ mortars ❑ ahnvp nr ❑ halnw 4ha uncl I, b) Top of bottom floor (including basement, crawlspace, or enclosure) is _ _ El feet ❑ meters El above or El below the LAG E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 91see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or [] below the HAG. E3. Attached garage (top of slab) is _ _ ❑ feet ❑ meters ❑ above or ❑ 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 onlIf no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain anagemenl ordinance? Ell Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION III The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A'(without a FEMA-issued or community- � isued 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's or Owner's Authorized Representative's Name Address City, State ZIP Code Signature Date Telephone Comments ❑ Check here ifiattachments. I r 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 GS-G10. In Puerto Rico only, enter lmeters. G1. El The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or a chitect 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. I' 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: _ _ El feet ❑ meters . Datum G10. Community's designfloodelevation: ❑ feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature Date I Comments Q Check here if attachments. ii I' see, 886 -INETTLES - BLVD. city slate Z-IRCode,-'-: TIENSEN BEACH FLORIDA 34957 If 400 the,86466 'effifkat ' to qbWj* NFIP;go Od insurance affix at least lfmib,bUhdhg-':photographs the instruc or s far Item A6 y 'Idenuf all hot" phs:*.lth-, date. tak6rr, uFront'-Mio-W, :and if -required .:0: - v -:46d 'LO, i t. vier* `�t sub�rrng gore drd phofophotographsphotographsV*O --:on,!:,,thl6. page,use tho, -Conflnuariion Pop` io follol r,'. FRONT 05/29/2015 REAR 05/29/2015 IDE 05/29/2015