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Home My WebLink AboutELEVATION CERTIFICATE 7-29-15U.S. DEPARTMENT OF HOMELAND SECURITY E L. � $, � 0! O N CERTIFICATE FEDERAL EM RGENCY MANAGEMENT"AGENCY j ;FMB No. 1660-0008 National Floo1/nsurance i Program important: niad the instructions on pages 1-9. - Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FORJNSURA:] NCE yCOMPHNY Al. Buildin" Owner's Name EDWIN & LESLEY CEHELNIK A2. Bl Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. "Company NAIC Nuritber r .rr 10701 SOUTH OCEAN DRIVE #697� .• �' City J :NSEN BEACH State FL ZIP Code 34957 / G (N A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 98 VE , TURE OUT A4. Buildinig Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitu e/Longitude: Lat. 27°16'04.5" N Long. 8l12*27.7" W Horizontal Datum: ❑ NAD 1927 0NAD 1983 A6. 'Attach�at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1 B A8. For a 'bilding with a'crawlspace or enclosure(s): A9. For a building with an attached garage: a) Sq are footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 123 sq ft b) Nu, ber of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or nclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) To al 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) En lineered flood openings? ❑ Yes ❑X No d) Engineered flood openings? ❑ Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP dommunity Name & Community Number B2. County Name B3. State UNINCOIQ 120285 ST. LUCIE FL t- - ----- B4. Map/,anel 1,11 Number 65. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 121 A C 0314 J 02/16/2012 Effective/Revised Date Zones) AO, use base flood depth) 11 02/16/2012 AE 8.0 B10. Indica a the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑X FIRM ❑ Community Determined ❑ Other/Source: Bl 1. Indica a elevation datum used for BFE in Item B9: ElNGVD 1929 ❑X NAVD 1988 1-1 Other/Source: _ B12. Is the uilding located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? El Yes ❑X No Designation Date:_ L] CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Buildin II 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. O C2. Elevau ns - 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 °ccording to the building diagram specified in Item A7. In Puerto Rico only, enter meters. dark Bench Indicat Utilized: 94 77 A02 RM1 FLDT Vertical Datum: NAVD 88 elevation datum used for the,elevations in items a) through h) below. ❑ NGVD 1929 ❑X NAVD 1988 ❑ Other/Source: /Datu fused for building elevations must be the same as that used for the BFE. a) Top Check the measurement used. f bottom floor (including basement, crawlspace, or enclosure floor) 7.0 X❑ feet El meters b) Top if the next higher floor N/A., 0 feet ❑meters c) Bott +m of the lowest horizontal structural member (V Zones only) N/A._ ❑ feet ❑ meters d) Atta Low�gst lhed garage (top of slab) 4.1 0feet El meters ❑ ❑ e) elevation of machinery or equipment servicing the building N/A._ feet meters (Des'cnbe 0 Low'jst type of equipment and location in Comments) adjacent (finished) grade next to building (LAG) 3.9 feet ❑ meters g) Higllii st adjacent (finished) grade next to building (HAG) 4.3 ❑X feet ❑ meters h) Lowllllst adjacent grade at lowest elevation of deck or stairs, including structural support VA._ ❑ feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certiVelevation information) 1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understa 'd that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑X Chec here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ElChecl here if attachments. licensed land surveyor? ❑X Yes ❑ No Certifier's Name EARLE R. STARKEY License Number 004459 Title PROiFESSIONAL LAND SURVEYOR Company Name ACCURIGHT LAND SURVEYING INC. /Sig State FL ZIP Code 34994 Date 07/29/2015 Telephone 772-286-7694 J013#1320-70-01 UC CE SEAL HER - PLS #4459 FEMA Forj'ji O 0-33 (7 See reverse side for continuation. Replaces all previous editions. IELEVAT1O1d CERT11=1Cf' T_`_ IMPORTANT: In these spades,, ;/ the corresponding information from Sect 4. FOR INSURANCE COMPAP(Y USE ,�.. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number �� 10701 SOUTH OCEAN DRIVE #697_ City JENSEN BEACH State FL ZIP Code 34957 Company NAIC Number �; tt x ,` 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. C 7! Signature . STARKEY Date 07/29/2015 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) 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 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, crawlspace, or enclosure) is _— El feet El meters El above or ❑ below the HAG. b) Top 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 _ _ ❑ feet ❑ meters El above or below the HAG. E3. Attached garage (top of slab) is _ _ ❑ feet ❑ meters Elabove 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 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 FEMA-issued 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's 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: _ _ ❑ feet ❑ meters Datum G10. Community's design flood elevation: _ _ ❑ feet ❑ meters Datum Local Official's Flame Title Community Name : Telephone Signature Date Comments Check here if attachments.