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Home My WebLink AboutELEVATION CERTIFICATE.5LC- )�f Z-o374 U.S. i✓PARTMENT OF HOMELAND SECU; ^` `)MB No. 1660-0008 Fede dal :Emergency Mahagement Agency i�cpiration Date: November 30, 2018 Natio ��al'Flood Insurance Program SCANNED ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. stx', Ludy could/ Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/comoanv. and (3) building owner_ l SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al BuBuilding Owner's Name Policy Number. P OENIX REALTY HOMES A2 ! Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number. 12 QUEEN GUINEVERE COURT State ZIP Code IICity FT. PIERCE Florida 34949 A3� Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) L E, BLOCK 2, QUEENS COVE UNIT 1 A4� Building Use (e.g., Residential, Non Addition, -Residential, Accessory, etc.) RESIDENTIAL (SLAB) A5 Latitude/Longitude: Lat. 27.51551 N Long. 80.32235W 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 1 B A8 I � For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A 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 Z No A . 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 d) Engineered flood openings? ❑ Yes 0 No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bf NFIP Community Name & Community Number B2. County Name B3. State B4. lNumber Map/Panel B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zones) B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 12111 C0089 J 02-16-2012 Revised Date 02-16-2012 AE 5 B I0. 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: B 1. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: B 2. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No I Designation Date: ❑ CBRS ❑ OPA FE41 A Form 086-0-33 (7116) Replaces all previous editions. Form Page 1 of 6 ELE,, ATION CERTIFICATE 1" 013 No. 1660-0008 _�'tpiration Date: November 30, 2018 IMPO TANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Build°ng Street Address (ncluding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 121 UEEN GUINEVERE COURT City it State ZIP Code Company NAIC Number FT. IERCE Florida 34949 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building 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. C2.1 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 A7. In Puerto Rico only, enter meters. Benchmark Utilized: K-633 Vertical Datum: NGVD 29 Indicate elevation datum used for the elevations in items a) through h) below. ❑x NGVD 1929 ❑ 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, crawlspace, or enclosure floor) 6.80 0 feet ❑ meters i I� 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) 6.24 0 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) N/A ❑ feet ❑ meters fl Lowest adjacent (finished) grade next to building (LAG) 5.40 ❑x feet ❑meters g) Highest adjacent (finished) grade next to building (HAG) 5.80 x❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A ❑ feet ❑ meters t 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 cartify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false Ste fement may be punishable by fine orimprisonment under 18 U.S. Code, Section 1001. W sire latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes ❑ No ❑ Check here if attachments. Certifiers C Name License Number ARLES H. BLANCHARD PSM5755 Tit e P ESIDENT P I c; C .inpany Name MRIDIAM LAND SURVEYORS LLB A 1147 dress INDIAN RIVER BLVD, STE 201 Ci " State ZIP Code V II BEACH Florida 32960 Si 'n to Date Telephone Ext. (772) 794-1213 Coby III all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. C .mments (including type of equipment and location, per C2(e), if applicable) P NAIL&DISK IMARY BENCHMARK IS USGS MONUMENT K-633, ELEVATION 19.18'NGVD 29. SECONDARY BENCHMARK IS FOUND PK (ILLEGIBLE) CENTELINE CUL-DE-SAC QUEEN GUINEVERE COURT; ELEVATION 4.33' NGVD 29. NO A1C PAD TO D�TERMINE C-2-E. LONGITUDE & LATITUDE DETERMINED USING HANDHELD. GPS DEVICE. THE CONVERSION FACTOR B �'TWEEN i� i I NGVD 1929 AND NAVD 1988 IS-1.48'. THIS WAS DETERMINED USING CORPSCON FOR WINDOWS VER. 6.1.1. Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 - il- ELE ATION CERTIFICATE�__,� ' CAB No. 1660-0008 `�;piration 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: 121 O UEEN GUINEVERE COURT City I'I State ZIP Code Company NA_IC Number FT. IERCE Florida 34949 j SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For iones AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, com ente fete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, meters. E1. rovide 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, crawispace, 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. i 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), e next higher floor (elevation C2.b in he diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. it ttached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. op of platform of machinery and/or equipment ervicmg the building is feet meters ❑ ❑ ❑above or ❑below the HAG. E5. one AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's ioodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. j' SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The II roperty owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or com 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. I, Pro 'erty Owner or Owner's Authorized Representative's Name II Add 'ess City State ZIP Code fi Sig ature Date Telephone I Co I °ments i I I j j� ' ❑ Check here if attachments. Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELE,, ATION CERTIFICATE "MB No. 1660-0008 - _ d(piration Date: November 30, 2018 IMPO TANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Build" g Street Address (ncluding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. - Policy Number: 121 ;UEEN GUINEVERE COURT City I State ZIP Code Company NAIC Number FT. IERCE Florida 34949 it 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 use in Items G8-G10. In Puerto Rico only, enter meters. G1. f ❑ 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.) i A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) G2. I'❑ or Zone AO. G3. �r_j The following information (Items G4-G10) is provided for community floodplain management purposes. it G4. IPermit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial. Improvement i G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum i G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum 1310: li Community's design flood elevation: ❑ feet ❑ meters Datum Lo I Official's Name Tale I Co�,munity Name Telephone Sig 'ature Date 11 Co I i I I "ments (including type of equipment and location, per C2(e), if applicable) I i i I II❑ - Check here if attachments. FEJiA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELE, ATION "° ALDING PHOTOGRAPHS 413 No. 1660-0008 CERTIFICATE Continuation Page _ .,;piration Date: November 30, 2018 IMPO , TANT: 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: 121 QUEEN GUINEVERE COURT City State ZIP Code Company NAIC Number FT. �IERCE Florida 34949 If submitting more photographs than will fit on the preceding page, affix the additional photograph's below. Identify all photographs wit date date taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and "Left Side View." When applicable, p ographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. I I� I I Y 4I I C/y�• V�[ S4 N y'i4L1t�':,�K � C' .! 1 � � .i� `�. � � {i •h' ^'i 4�r�wL-� $ i'Lt�-^i'pa+q+As ,„... ..., * p-..-`°,x. y .. �'^ �^p '`w. ...,.r„i� tr z f `A' ■ �++. .,. •'a .-sue.. �m.,>+ z y, A '`2.9`� x"' mi r ayv„+` f-s,t,e.,,Y {.rr, ...,.'`�'' ,,. "`r;= -^y sr.->.E� 4^� r'"`",,.ak �•, .�.-,� sa..-.�,,—,{'✓- - i'Xa. s•�t,��rT.r `cj (�, _,"wy,^.t'� ,° `5 it" - £ !'�' ' w ram. E v� 4, w, g-:- }—'+i.�...�� .. y..y.'7Ayv"74h -. "t -R"4'+�Y'CJ�"x tad,• . .,,r+aY e t I i�ii„e�47..f.su �„... rr.L�.t.,. •'.'{'�'' `7-.L�2.�:.�. .� il�"v:'_'�iii _ .. Photo Three Pho�'o Three Caption RIGHT SIDE VIEW (REAR) ,Clear PhotglThreef w ali;<�Jk - M� ^ r• yes"± �"� '� J,��65� .eF -_ +� �� Z°�d, �'r to :^• `:-. .,'r rrI '�'y,�'*'$'�,:� c�' 2sfY;d � Photo Four Phi ito Four Caption 'LEFT SIDE VIEW (SIDE) ClearPhoto,Four FE .A Form 086-0-33 (7115) Replaces all previous editions. Form Page 6 of 6 ELEATION CERTIFICATE Q'JILDING PHOTOGRAPHS -,'n6 No.1660-0008 See Instructions for Item A6. 4piration Date: November 30, 2018 IMPO TANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Build ng Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 121 UEEN GUINEVERE COURT City II State ZIP Code Company NAIC Number FT. �,,IIIERCE Florida 34949 If u''in g the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the inst suctions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Le Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or ven,ls, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. r � I }y Su t l ,„w i II Photo One Phalo One Caption FRONT VIEW. ' Clear Photo Onef' I' > + Ti5 ��""`4{G "'Y.�.,}SyPG" qM sf"1`..� �''S`�1�"i=3 y`�"'• 1' � .A Z2) A - u .x, am ' • ` ',.III .• Photo Two Photo Two Caption REAR VIEW Giear Photo Two Form,086-0-33 (7/15) Replaces all previous editions, Form Page 5 of 6