HomeMy WebLinkAboutELEVATION CERTIFICATE 6-11-18U.S. DEPARTMENT OF HOMELAND SECURITY
008
Federal Emer enc Management Agency OMB No. 1 ate: Nov
9 Y 9 9 Y Expiration Date: November 30, 2018
National II food Insurance Program
i� BONNE® ELEVATION CERTIFICATE
t� ��� mw Important: Follow the instructions on pages 1-9.
Copy all ages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al.
B,Ading Owner's Name
Policy Number:
D.R.
O RTO N
A2.
Bl;' ilding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
8636
� OBBLESTONE DRIVE
l
C
�y State ZIP Code
F
), RT PIERCE Florida 34945
A3.
�operty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
2326-
3 00-0068-000-3 Lot 63
1
A4. Eiilding
Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A&
Lii titude/Longitude: Lat. 27°24'38.24" N. Long. 80°24'48.94" W. Horizontal Datum: ❑ NAD 1927 x❑ NAD 1983
A6. P
ttach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7.IBuilding
Diagram Number 1A
A8. F
li r a building with a crawlspace or enclosure(s):
Square footage of crawlspace or encfosure(s) N/A sq ft
i
b
Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A
c
Total net area of flood openings in A8.b N/A sq in
d
Engineered flood openings? ❑ Yes ❑x No
A9. F
r a building with an attached garage:
a
Square footage of attached garage 400.00 sq ft
i
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
I
I
it SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NI�IP
Community Name & Community Number
B2. County Name
B3. State
St. LL
I ie County 120285
Saint Lucie
Florida
B4. M
N
'p/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s)
Date
Effective/
Zone(s)
(Zone AO, use Base Flood Depth)
lumber
Revised Date
12111
30170
I�
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 ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. ilndicate
elevation datum used for BFE in Item B9: ❑ NGVD 1929 x❑ NAVD 1988 ❑ Other/Source:
612. 'Is
the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes x No
,Designation
Date: ❑ CBRS ❑ OPA
FILE C0
FEMA I 'orm 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
• � II
ELE IATION CERTIFICATE
BUILDING PHOTOGRAPHS OMB No. 1660-0008
See Instructions for Item A6. Expiration Date: November 30, 2018
IMPO
FT'ANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building
8636
Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
dOBBLESTONE DRIVE
Policy Number:
City
FORT
State ZIP Code
PIERCE Florida 34945
Company NAIC Number
If usi
instructions
"Left
vents
Ig the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and
Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or
as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
i
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Ij
Photo One
Photo
Dne Caption Front ;Clear Photo One
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Photo Two
Photo
lwo Caption Back ;Clear Photo_Two
FEMA l f form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
ELEV ,,TION
BUILDING PHOTOGRAPHS OMB No.1660-0008
CERTIFICATE Continuation Page Expiration Date: November 30, 2018
IMPORT, NT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building!IStreet
8636 COBBLESTONE
Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
DRIVE
t
Policy Number:
City
FORT F
State ZIP Code
IERCE Florida 34945
I
Company NAIC Number
If subr
with:
photographs
itting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
dajte 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.
I
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II
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Photo Three
Photo
hree Caption Right Side ;Clear Photo Three
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Photo Four
Photo ,'bur
Caption Left Side ! Clear Photo=Four
FEMA Fprm 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6