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Home My WebLink AboutELEVATION CERTIFICATESCANNED U.S.'DEPARTMENT EPARTMENT OF HOMELAND SECURITY BY OMB No. 1660-0008 Feder, I Emergency Management Agency S�% Expiration Date: November 30, 2018 Nation:l Flood Insurance Program ��(' �� ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy II pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. 11 SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Ma iia Jeneva Andes Judilla and Edgar Galedo Judilla CT#15-141.100.063 A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: i Box No. 863ii Cobblestone Drive City State ZIP Code Fort Pierce Florida 34945 i A3. lProperty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 232 -600-0068-000-3, Lot 63 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 27°24'38.24" N. Long. 80°24'48.94" W. Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. - A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0.00 sq ft Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0 I) c) Total net area of flood openings in A8.b 0.00 sq in Id) Engineered flood openings? ❑ Yes x❑ No A9..I�or a building with an attached garage: +) Square footage of attached garage 400.00 sq ft ) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0.00 sq in d) Engineered flood openings? ❑ Yes ❑R No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State St. lucie County 120285 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) l Revised Date 1211 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 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11 Indicate elevation datum used for BFE in Item 69: ❑ 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 ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ,t ELEVATION CERTIFICATE OMB No. 1660-0008' Expiration Date: November 30, 2018 IMPdRTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buil ng Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 863E Cobblestone Drive City State ZIP Code Company NAIC Number Fort ierce Florida 34945 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x 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. Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: AF6653 Vertical Datum: NAVD 88 Indicate 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. a) Top of bottom floor (including basement, crawispace, or enclosure floor) 18.32 ❑x feet ❑ meters b) Top 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) 17.71 ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 17.98 feet meters ❑ ❑ (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 17.50 ❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 17.80 ❑ feet ❑ meters , h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A ❑ feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Thi certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. l c statement dify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Ille We latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Cer ifiets Name License Number Th �nas P. Kiernan 6199 ��e��i�,�� ,°° - �� ,gyp,.,,....,,. Titl' Pro essional Surveyor Um .. I'i 2 Co pany Name Cul epper & Terpening. Inc. = o • =T _ • �a • Ad ess 298 , South 25th Street delSurgur'4 ej � o�� °. Cit Fo State ZIP Code Pierce Florida 34981 Sig �ature Date Telephone Ext. 464-3537 206 7.�l�------"= j 1 (772) Cop all pages of this Elevation Certificate and all attachments for (IJ co munity official, (2) insurance agent/company, and (3) building owner. Con ments (including type of equipment and location, per C2(e), if applicable) Equ ' pment in C2(e) refers to A/C pad on rear of building FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 \__. EL :NATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018. IMP RTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buil ing Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 863 • Cobblestone Drive City l State ZIP Code Company NAIC Number Fort tierce Florida 34945 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For ones AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, com fete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, ente meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below he highest adjacent grade (HAG) and the lowest adjacent grade (LAG). Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. or Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), he next higher floor (elevation C2.b in he diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. �,I ttached garage (top of slab) is Elfeet Elmeters ❑ above or E]below the HAG. E4. Top of platform of machinery and/or equipment lservicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. K.one AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's oodplain management ordinance? E] Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The roperty owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or com II unity -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Prop rty Owner or Owner's Authorized Representative's Name Add r 'ss City State ZIP Code Sign ture Date Telephone Comr ents ❑ Check here if attachments. FEMA!Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 III ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMP ,RTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buil Street Address (including Apt., Unit, Suite, and/or Bldg.,No.) or P.O. Route and Box No. Policy Number: 863 Ing Cobblestone Drive City State ZIP Code Company NAIC Number Fort Oerce Florida 34945: SECTION G — COMMUNITY INFORMATION (OPTIONAL) The ocal official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete' Sect ons A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement useci in Items G8—G10. In Puerto Rico only, enter meters. Ili 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. ermit Number G5..,Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: New Construction Substantial Improvement P ❑ ❑ 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 G101I Community's design flood elevation: ❑ feet ❑ meters Datum LocE Official's Name Title Corr"unity Name Telephone Sign" ture Date Corr nents (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMb Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No. 1660-0008 See Instructions for Item A6. Expiration Date: November 30, 2018 1. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildling Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8636 Cobblestone Drive City I State ZIP Code Company NAIC Number Fort Pierce Florida 34945 If Ling the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the insi'fuctions for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View"; and, if required, 'Right Side View" and ' Legit Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or ver{ts, II as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. {' �i'y- -,wri�' '. y �� _ l f- � Li y�3' � s �„t •q,, �Y Y �rh �� h' '� 4 ¢{�{4��' 4 z 1 t 1h k ..•�.-}b v�e''�'zYlE"��, 5* �'-`='e�1��f��4�y��S��i`.fh.:. y1 A, � K ..< ,«. .'.n'"'�".f' t v�gt�' �I {go.s�,'�'rts��._ 'a �4t�'�.f 7 z-.^ei4tx q� Etis.,iu-1e.,"�"zH.*x' Photo One Phoiio One Caption Front 2/28/19 Clear Photo One ;. a e' Photo Two Pho o Two Caption Rear 2/28/19 Clear Photo Two, FEMb Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 El EVATION CERTIFICATE BUILDING PHOTOGRAPHS OMB No.1660-0008 Continuation Page Expiration Date: November 30, 2018 IMPO TANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Build �g Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8636 Cobblestone Drive City State ZIP Code Company NAIC Number Fort(fierce Florida 34945 If s )miffing more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with ' date taken; "Front View" and "Rear View'; and, if required, "Right Side View" and "Left Side View." When applicable, phol 'I graphs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. at sts - r 2 h, a Photo Three Phot i Three Caption Left Side 2/28/19Clear Photo:Three< •' *� ` .:<,S � -G 'it� Y 31 3 h V -� � - ,"� j•�}y�q�i�.��' 4. .��,{��, ,5�� 7�"� I�IAX J� f ..jk1�`T�y�.+-,� f}. �'�: ��,�'X=`r`�� •`v3'} i f'.S:r Y.��l�""�.�+rT'x' ?Eey>#k�:3• ��$� `$3 W�-r�� l Photo Four I'i Phot Four Caption Right Side 2/28/19 Clear Photo. Four: FEMPForm 086-0-33 (7115) Replaces all previous editions. Form Page 6 of 6