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Home My WebLink AboutELEVATION CERTIFICATE 3-1-18U_5. DEPARTMENT OF HOMELAND SE_, _,k�ITY��® OMB No. lssa0008 Fed gal Emergency Management Agency Expiration Date: November 30, 2018 Natio al Flood Insurance Program BY ELEVAT160-141Wff iCATE jIrnportart: Follow the instructions on pages 1-9. " I Con all oases of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/cgmpany, and (3) building owner. l SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE A II. Building Owner's Name Policy,, Number. P ;� PEW REALTY HOMES Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number. Box No 1 1 QUEEN GUINEVERE COURT j City State ZIP Code FT. PIERCE Florida 34949 3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) T E, BLOCK 2, QUEENS COVE UNIT 1 I4. Building Use (e.g., Residential, Non -Residential* Addition, Accessory, etc.) RESIDENTIAL ![ - . Latitude/Longitude: Lat 27.51551N Long. 80.32235W Horizontal Datum: ElNAD 1927 ❑x NAD 1983 6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. 7. i Building Diagram Number 1B 8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosures) NIA sq ft 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 0.00 sq in I d) Engineered flood openings? ❑ Yes FX1 No 9. For a building with an attached garage. a) Square footage of attached garage 630.00 sq ft i b) 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 I d) Engineered flood openings? ❑ Yes x❑ No III , SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State T LUCIE COUNTY 120285 ST. LUCIE 4 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 CO089 J 02-16-2012 02-16-2012 AE 5 I B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile x❑ FIRM ❑ Community Determined ❑ Other/Source: I i B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: 1 Area (OPA)? ❑ Yes ❑x No B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Designation Date: ❑ CBRS ❑ OPA i { MA Form 086-0-33 (7/15) Replaces all previous editions. f Form, Page 1 of 6 �I y EL OVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT:O In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building ing Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 121 QUEEN GUINEVERE COURT s City' State ZIP Code (PIERCE Company NAIC Number FT. Florida 34949 I 1 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C . Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction* j x❑ Finished Construction new Elevation Certificate will be required when construction of the building is complete. C . 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, AWAO. .I*A Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico gnly, enter meters. Benchmark Utilized: K 633 Vertical Datum: NGVD 29 Indicate elevation datum used for the elevations in items a) through h) below. i ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: the measurement used. Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 6.80 (x❑ feet ❑ meters b) Top of the next higher floor 18.16 ' x❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 625 x❑ feet ❑ meters jl e) Lowest elevation of machinery or equipment servicing the building 6.75 l x❑ feet ❑ meters (Describe type of equipment and location in Comments) I f) Lowest adjacent (finished) grade next to building (LAG) 6.10 i ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 620 j x❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ❑feet ❑meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION his certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. l understand that any false may be punishable by fine or imprisonment under 18 U_S_ Code, Section 1J_001. ? 0 ❑atement /ere latitude and longitude in Section A provided by a licensed land surveyorYes No ❑(Check 1 here if attachments. ertiflees Name License Number I �HARLES H. BLANCHARD PSM5755 i itle II RESIDENT {c pompanyName ERIDIAM LAND SURVEYORSil yt ,'ddress - H= H e r o i717 INDIAN RIVER BLVD, STE 201 { city State ZIP Code ERO BEACH Florida 32960 ignature Date Telephone Ext.� (772) 794-1213 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/cbmpany, and (3) building owner. comments (including type of equipment and location, per C2(e), if applicable) IIRIMARY BENCHMARK IS USGS MONUMENT K-633, ELEVATION 19.1&NGVD 29. SECONDARY BENCHMARK IS FOUND PK AIL&DISK (ILLEGIBLE) CENTELINE CUL-DE-SAC QUEEN GUINEVERE COURT, ELEVATION 4.33` NGVD 29. A\C PAD ORTHWEST SIDE OF BUILDING USED TO DETERMINE C-2-E. LONGITUDE & LATITUDE DETERMINED USING HANDHELD GPS ) EVICE. THE CONVERSION FACTOR BETWEEN NGVD 1929 AND NAVD 19881S-1.48`. THIS WAS DETERMINED USING i ORPSCON FOR WINDOWS VER. 6.1.1. F iMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 2 of 6 I � EL OVATION CERTIFICATE -"'DMB 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 121 ',QUEEN GUINEVERE COURT City; State ZIP Code 34949 Compeffny NAIC Number FT. �,IERCE Florida I 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 E1—E5. If the Certificate is intended to support a LOMA or LOMR F request, co plete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. lI Provide elevation information for --the following and check the appropriate boxes to show whether the elevation is above or below Ithe highest adjacent grade (HAG) and the lowest adjacent grade (LAG). 6) Top of bottom floor (including; basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including, basement, j crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams " 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 I the diagrams) of the building is ❑ feet ❑ meters El 'above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑'above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5.; 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 E] No ❑ Unknown. The local official must certify �is information in Section G. SECTION F —!PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION Theproperty owner or owner's authorized representative who completes Sections A, B, and E for Zone A (wiithout a FEMA-issued or co Ilmunity-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Pro" erty Owner or Owner's Authorized Representative's Name AdP Tess City State ZIP Code Sig,' ature Date Telephone . i j l Co ' ments I ! I f i 1 I i i 0 Check here if attachments. FE A Form 086 0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 i •I EL. ,. ATICN CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMP II RTANT: In these spaces, copy, the corresponding information from Section A. FOR INSURANCE COMPANY USE Bui ing Street Address (including Apt, Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number 121!QUEEN GUINEVERE COURT Cq State ZIP Code Comp NAIL Number FT. !PIERCE Florida 34949 my it SECTION G — COMMUNITY INFORMATION (OPTIONAL) Th 1, local official who is authorized by law or ordinance to administer the community's floodplain managemept ordinance can complete Se ° ions A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement us id in 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 communityofficial completed Section E for a building located in Zone A without a FEMA issued or community -issued BFE ❑ p g ( ) or Zone AO_ G3 ; ❑ The following information (items G4- G10) is provided for community floodplain management purposes. G41 Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G I I ` This permit has been issued for. ❑ New Construction Q Substantiat Improvement G8 I Elevation of as -built lowest floor (including basement) meters El feet ❑ Datum of the building: G9 ' BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G1 0. Community's design flood elevation: ❑ feet ❑ meters Datum Lo II 1 Official's Name I Title i 1 i I Co" munity Name Telephone I III Si 'nature Date { Co" ments (including type of equipment and location, per C2(e), if applicable) I ' I i ! ! I II I ' 7 I I I I I 1 Check here if attachments. FE A Form 086-033 (7115) z Replaces all previous editions. i Form Page 4 of 6 i i � I EL NATION CERTIFICATE] BUILDING PHOTOGRAPHS OMB No. lsso-000a See Instructions for Item A6. Expiration Date: November 30, 2018 IMP RTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Bui 'ding Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 121 1QUEEN GUINEVERE COURT Ci State ZIP Code Company NAIC Number FT. iPIERCE Florida 34949 If sing the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the inE tI ructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View'; and, if regdired, `Right Side View" and "L Ilft Side View." When applicable, photographs must show the foundation with representative examplO of the flood openings or ve , ts, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. y aj} 'S J £ N � MW f m p7f ay`7 %F �3 .di, III I� �A ------- Photo Photo One Ph "to One Caption FRONT VIEW I I Clear PhQYoAne .� e� `N��•~"'.�"�!—� fi ) K..F'1'A/i+ .�.+• Fa ��' a'4`. Jim` ^s4' n� � .i.wr..zi+L 4^Y ..�Y _ yr• YI +tat qi IL. _ r Photo Two 1 Ph Ito Two Caption REAR VIEW j Clear Photo Two FE I'A Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 EL VATION CERTIFICATE' BUILDING PHOTOGRAPHS Continuation Page OMB No. 1660-0008 Expiration Date: November 30, 2018 -. - M -.umber Ew11rtTt�-1rrM,,M1r.T1-3.�.• 11011 1:9 MO Kell] II CM =1 V • _r .. ._ � f Y."i '44.14j+Y:w`6t•3•r.0 4 -^'� �, �F t Yl+P9!'b-yrv°�" - "I�. f CCC 4 f� l.r{» '�y �,X �"^•dcSkw 4 � f" r{ �' '�? �M � � �' `' S �' 1"y ,7 3^ .:? v- ° �, la� i� j � .� `+_ .-,� Y`K' '� `^' yg.t„ ti • r __ .•� yt i Y �'" �f-.ty, $ kT a�' ,yAS 7` .. 4S` ?"A� 7 ` F•W �'S. n.- 1 ��`ri iY �.•. i c+�•L` 6.S�C -�+ �l� �, F 1r' }y„�V,. F 3�. T�1++� �v ,L' ; 1�. + { ..r �� d�ya 41w t� i^ �k'`�1 "Y a4 ^� +,x 1 C�. tt i.� �� JY:• 'ryy ; `'&' J' frjy• r l J -.�k.' i2a.Hf1`fa3+' ''t`i-n ^° 7:i -yc' Yf.r+ 1 . S•,+. fi a as J� tI i,J az • _ , . a RAIM F MA Form 086-0-33 (7115) Replaces all previous editions. Form Page 6 of 6 I