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Home My WebLink AboutELEVATION CERTIFICATE 10-9-18U`.S. DEPART TENT OF HOMELA� ;SECURITY Federal Emerg ncy Management ,,_ icy National Flood I 1 surance Program OMB No. 1660-0008 Expiration Date: November 30, 2018 AN\1 'r-U) ELEVATION CERTIFICATE BY Important: Follow the instructions on pages 1-9. QS. [[Lucia county Copy all pages;of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. II SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Buildingg Owner's Name Policy Number: D.R. HOR TION CT#15-141.100.063 A2. Buildir)'g Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box f�o. Company NAIC Number: 8636 COBBLESTONE DRIVE City I State ZIP Code FOR PIERCE Florida 34945 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Leg s6 on, etc.) 2326-6+0068-000-3 Lot 63 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. La etude/Longitude: Lat. 27°24'38.24" N. Long.80°24'48.94" W. Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. A �ach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. F r a building with a crawlspace or enclosure(s): Square footage of crawlspace or enclosure(s) N/A sq ft l Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A biI Total net area of flood openings in A8.b N/A sq in Engineered flood openings? ❑ Yes ❑x No FILE C013v A9. or a building with an attached garage: a) Square footage of attached garage 400.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name B3. State 1't. Lucie County 120285 III4. Saint Lucie Florida 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 2111 CO170 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 139: ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: 1)n these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Streef Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8636 COBBLESTONE DRIVE It City State ZIP Code Company NAIC Number FORT PIER E Florida 34945 1 �I SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. BuildiIIIng 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. 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. Co plete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Bel�chmark Utilized: AF6653 Vertical Datum: NAVD 88 In icate elevation datum used for the elevations in items a) through h) below. 'I ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. II Check the measurement used. r) Top of bottom floor (including basement, crawlspace, or enclosure floor) 18.30 ❑x feet ❑ meters LTop of the next higher floor N/A ❑feet ❑meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 17.70 ❑ feet ❑ meters e) 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 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 certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. l 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. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes No ❑ Check here if attachments. Certifier's Name License Number Thomas P. Kiernan 6199 .•`' �pMAS A . ,� ...., .• �censati., Title Professional Surveyor ,.( p/a�a •, . 17 i •� �Q /9 i,. o m � a' > gym: o ;.• �� '.5' Company Name Culpepper & Terpening. Inc. :' , Address 2980 South 25th Street ... •• ..bgj'�'b ,,e�or a;dM"".• City State ZIP Code Fort Pierce Florida 34981 Signature Date Telephone Ext. 1? (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. Comments (including type of equipment and location, per C2(e), if applicable) FEMA Form 086-0-33 (7/15) Replaces all previous editions. 'I Form Page 2 of 6 .. •r..-kik nrnTlC fl A TC ' OMB No. 1660-0008 Expiration Date: November 30, 2018 CLCVA 1 IVI,P VGr% I iF 11^ - -- IMPORTANT: 16 these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building StreefAddress (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8636 COBBL#STONE DRIVE City '1! State ZIP Code Company NAIC Number FORT PIERCE Florida 34945 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone/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 El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meI�ers. 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)�op 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. For 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 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. E Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. 5. 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. i' 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE' OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT:/in these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Stre#t Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8636 COBB§ESTONE DRIVE City State ZIP Code Company NAIC Number FORT PIECE Florida 34945 A SECTION G — COMMUNITY INFORMATION (OPTIONAL) The to (official who is authorized bylaw or ordinance to administer the community's floodplain management ordinance can complete Sectio A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used 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. G' . ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. 4. Permit Number G5. Date Permit Issued G6. Date Certificate of r/ Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) ❑ feet ❑ meters of the building: 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 Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPH" 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 Building Str et Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8636 COB LESTONE DRIVE Policy Number: City State ZIP Code FORT PI RCE Florida 34945 Company NAIC Number If using 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 Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vent , as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. Photo One Photo One Caption Front Clear Photo One Photo Two Photo Two Caption Back +'Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 .: 11 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No.1660-0008 f� Continuation Page Expiration Date: November 30, 2018 IMPORTANT:#n these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Stre 't Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 8636 COBBLESTONE DRIVE Policy Number: City ' State ZIP Code FORT PIE ,CE Florida 34945 Company NAIC Number If sub41g more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs ji with. dae taken; "Front View and "Rear View"; and, if required, Right Side View" and Left Side View." When applicable, photogr 1phs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo Three Photo Three Caption Right Side {Clear Photo Three Photo Four Photo Four Caption Left Side Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6