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Home My WebLink AboutELEVATION CERTIFICATE 6-11-18i U.S. 1 EPARTMENT OF HOMELAND SECURITY ��G� OMB No. 1660-0008 ` Federal Emergency Management Agency BY Expiration Date: November 30, 2018 I Nation I Flood Insurance Program � ELEVATIO ��C�ERTIFICATE Important: Follow the instructions on pages 1-9. Copy al (pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. I` SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. B' ilding Owners Name Policy Number: D.R. H10RTON A2. 1300ding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Bo No. 8632 C iBBLESTONE DRIVE City State ZIP Code FOR PIERCE Florida 34945 A3. Prop"�rty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 2326-600 0069-000-0 Lot 64 i A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitud /Longitude: Lat. 27°24'38.30" N. Long.80°24'38.30" W. Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach :t least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building) Diagram Number 1A A8. For a bu Iding with a crawlspace or enclosure(s): a) Squaz footage of crawlspace or enclosure(s) N/A sq ft b) Numb�I of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total nllt area of flood openings in A8.b N/A sq in I d) Engine ed flood openings? ❑ Yes ❑x No � A9. For a buildi with an attached garage: a) Square footage of attached garage 400.00 sq ft b) Number ofllpermanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A I c) Total net area of flood openings in A9.b N/A sq in d) Engineered openings? ❑ Yes ❑x No I II SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community,Name & Community Number B2. County Name B3. State St. Lucie County 10285 Saint Lucie Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12111 C0170 J 02-16-2012 02-16-2012 AE 16.5 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile 0 I i IRM ❑ Community Determined E her/So'urce: 5;� � B11. Indicate elevation datum used for BFE in Item B9: ❑ NfVDEILAV th r/Source: B12. Is the building locat Id in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA II FFMA Fnrm oRR_rL33 17/1 Fl �� Rcnlnrac .II --i—c c 4i4innc C...-.., r3__ . -1 -Tex ELE !ATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPO TANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildi g Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8632 �'OBBLESTONE DRIVE City I State ZIP Code Company NAIC Number FORT TIERCE Florida 34945 11 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. uilding elevations are based on: ❑X Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction I new Elevation Certificate will be required when construction of the building is complete. C2. • levations — 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. omplete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. enchmark Utilized: AF6653 Vertical Datum: NAVD 88 1 dicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. ii) Top of bottom floor (including basement, crawlspace, or enclosure floor) 18.30 0 feet ❑ meters Ili) Top of the next higher floor N/A ❑ feet ❑ meters �I) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters tl) Attached garage (top of slab) 17.70 ❑x feet ❑ meters Lowest elevation of machinery or equipment servicing the building N/A ❑ feet ❑ meters (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) N/A ❑ feet ❑ meters I Highest adjacent (finished) grade next to building (HAG) N/A ❑ feet ❑ meters Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ❑ feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This rtification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certr that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false state ent may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certifiers Name License Number 6199 Thom s P. Kiernan Title Profe �sional Surveyor - r V,a e' Company Name Culpepper & Terpening. Inc. rv:� Address 2980 outh 25th Street City State ZIP Code Fort Pi lFlorida 34981 erce Signa ire Date Telephone Ext. (772) 464-3537 206 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comrr ents (including type of equipment and location, per C2(e), if applicable) I =KAA Glum nAR_n-i A mi rN P—ln— oil —14innc Form Paoe 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPOI�TANT: 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 P.O. Route and Box No. Policy Number: 8632 OBBLESTONE DRIVE i City , State ZIP Code Company NAIC Number FORT iPIERCE Florida 34945 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, compl Ite Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter 0j eters. E1. Pfovide 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 ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. F r Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in th diagrams) of the building is E] feet ❑ meters ❑ above or ❑ below the HAG. E3. A lached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. T p of platform of machinery and/or equipment servicing the building is [:]feet ❑ meters ❑ above or ❑ below the HAG. E5. ZoIPe AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's flop dplain No Unknown. The local this information in Section G. management ordinance? ❑Yes ❑ ❑ official must certify SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The p4,perty owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or Comm {pity -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Prope Owner or Owner's Authorized Representative's Name Addres i City State ZIP Code Signat re Date Telephone Comm jets i Check here if attachments. G1=fl4A Grim nQR_lL44 /7/1r.\ D._.-I--.,...,II .............. -A;+;--- M-- Dino 1 of R ELE I,- - d CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPO ITANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildi g Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8632 OBBLESTONE DRIVE City I State ZIP Code Company NAIC Number FORT FIERCE Florida 34945 I SECTION G — COMMUNITY INFORMATION (OPTIONAL) The to I al official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sectio s A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used i i 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. P Fmit 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 01, of as -built lowest floor (including basement) he building: ❑ feet ❑ meters Datum G9. B�E or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. C Immunitys design flood elevation: ❑ feet ❑ meters Datum Local O icial's Name Title i Commu iity Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. PPRAA Pnrin n;zn_n_1A MIR\ D—In — nil nr—A-- c441 no Fnrm Pon= A of A ELE CATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No. 1660-0008 See Instructions for Item A6. Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE BuildiO Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8632 iOBBLESTONE DRIVE Policy Number: City I FORT State ZIP Code PIERCE Florida 34945 Company NAIC Number If usi g the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents�ide as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. Photo One Photo O 1 e Caption Front -f'-Clear Photo One Photo Two Photo Twdi Caption Back Clear Photo Two CCflIIA C...' l%OQ r% 00 /7/4C\ n--'---- -1.-__------------- ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No. 1660-0008 Continuation. Page Expiration Date: November 30, 2018 IMPO14,'TANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildi g Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8632 OBBLESTONE DRIVE Policy Number: City FORT PIERCE State ZIP Code Florida 34945 Company NAIC Number If su with: date phot graphs mitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs taken; "Front View" and 'Rear View"; and, if required, 'Right Side View" and "Left Side View." When applicable, must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo Three Photo T i ree Caption Right Side Clear P46i&Three I Photo Four Photo Fo r Caption Left Side ;,Clear Photo Four