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HomeMy WebLinkAboutELEVATION CERTIFICATE`Si i iriLi i i vi i iviVi�i� �F Ui %i i -i qderal,'Emergency Management k., National Flood Insurance Program IOM13 No. 1660-0008 Expiration Date: November 30, 2018 SCANNED BY Copy all ELEVATION CERTIFICATE . Important: Follow the instructions on pages 1-9. and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner. II SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Bdilding Owner's Name ED & Policy Number: ,p LESLEY CEHELNIK A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: BOX No. 10701 S11OUTH OCEAN DRIVE #697 Ci '' de C P State o JENSEN BEACH FLORIDA ZIP Co 34957 I"perty A3. Pr Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 98, ;DENTURE OUT n A4. Bu11'�ding Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latiltude/Longitude: Lat. 27°16'04.5"N Long.-80°12"27.7"W Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. i AT Building Diagram Number 113 building with a crawlspace or enclosure(s): A8. Forlquare a) i�footage of crawlspace or. enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c)al net area of flood openings in A8.b N/A sq in 1I d) Ingineered flood openings? ❑ Yes ® No A9. For 'building with an attached garage: 11 a) Sllquare footage of attached garage 112 sq ft b) N I mber of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 2 c) T IIItalnet area of flood in A9 b 1152 in openings sq d) Engineered ficod openings? ® Yes ❑ No III III SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP bommunity Name & Community Number B2. County Name 63. State UNICORP �1120285 ST. LUCIE FLORIDA B4. Map/Panel Numb °t B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) J Date ©L � l lam' I Z Effective/ Revised Date AE (Zone AO, use Base Flood Depth) c7 I ! (a 1 Z' 7.0 B10. Indi IIII to the source of the Base Flood Elevatlon (BFE) data or base flood depth entered in Item B9: ❑ F7S Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: i B12. Is th l building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No I Ian Desi ation Date: ❑ CBRS ❑ OPA i FEMA Form 0186-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 I Building Photographs See Instw>ctions for Item A6. Irmmce V � � t� *"�• KJ r"., u► uk IwEe, awOr -sag. No.) or P.O. Route and Box No. Pifty -Number 10701�1 SOUTH OCEAN DRIVE #697 FLORIDA If using t, Elevation Certificate to obtain NFIP flood insurance, affix at least two 6�ild photographs below according to the inst 'ructions for Item A6. Identify all photographs with: date taken; "Front View' and "Rear V ewe; and if Page, if required, "Right Side vi and 'Left Side brew." If submitting more photographs than will fit on this page, use the C following FRONT 01/22/2016 II REAR 01/22/2016 1o11 SIDE 01/22/2016 TABLE 9-MODEL SIZES DEL NAME MODEL NUMBER MODEL SIZE (in.) t COVERAGE (sq. ft.) 1540-52Q;- 1-6 W',X 7 1 200,' 6. 1540-510 153/411 X 7 3 /411 200. :rhead Door 1540-524 153/411 X 731419 200 I-rhead Door 1540-514 153/41' X 73 /411 200 VENT"" VENTO Overhead Door 1540-570 1540-574 1411 X 83/4vl 1411 X 83 /411 A00 200 ,cker 1540-511 16" X 161, 400 cer 1540-521. 16" X 16" 00 + I 11111, 1 tiquaru root = m ELEVA'ION CERTIFICATE r--� Vt �:..J ItlV. iVL•V VVVV f , Expiration Date: November 30, 2018 IMPORT/T�,IT: In these spaces, copy the ' esponding information from Section A. FOR INSURANCE COMPANY USE Building treet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 10701 SO��UTH OCEAN DRIVE #697 City III State ZIP Code Company NAIC Number JEN ,IIEN BEACH FLORIDA 34957 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Build ing elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® 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/AIA30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specked in Item A7. In Puerto Rico only, enter meters. Ben&mark Utilized: 94 77 A02 RM1 FDOT Vertical Datum: NAVD 1988 Indi hate elevation datum used for the elevations in items a) through h) below. I❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: Dat m used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Topof bottom floor (including basement, crawlspace, or enclosure floor) 7 0 ® feet ❑ meters b) op of the next higher floor 1 6 4 ® feet ❑ meters c) Bll ttom of the lowest horizontal structural member (V Zones only) N / A ❑ feet ❑ meters d) �ttached garage (top of slab) 4 1 ® feet ❑ meters e) west elevation of machinery or equipment servicing the building 9 0 L, ® feet ❑ meters (, e--c- type of equipment and location in Comments) f) AWest adjacent (finished) grade next to building (LAG) 3 9 ® feet ❑ meters g) 11 adjacent (finished) grade next to building (HAG) `I' 3 ® feet ❑ meters I1ghest h) L west adjacent grade at lowest elevation of deck or stairs, including N / A ❑ feet ❑ meters s iructural support III SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certication is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify tli'at the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement) may be punishable by nine or imprisonment under 98 U.S. Code, Section 1001. Were latitllllllll de and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No ® Check here if attachments. Certifiers dame License Number JOB #1320-70-01 EARLE R. 1STARKEY PLS #004459 Title III PROFESSIONAL LAND SURVEYOR Company ame ACCURIGHT LAND SURVEYING INC. Address I 1 01 DECKER AVENUE #419 - (�1/22/2016 REVISED 09/07/2016 City S State ZIP Code FL 34994 PLS #004459 Signature I Date Telephone 01 /22/2016 772-286-7694 Copy all pa k es of this Elevation a a ac menis for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) A9-C IS A SIDED CARPORT WITH 1 FLOODVENT MODEL #1540-520 (200. SQ. INCHES) & I USED THE CARPORT ENTRANC 96 INCHES WIDE & WENT UP 24 INCHES (952 SQ. INCHES) C2-E BOTTOM OF TANKLESS WATER HEATER. FEMA Form �86-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6