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HomeMy WebLinkAboutELEVATION CERTIFICATE 10-18-14U.S. DEF"RTIy,ENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMGENCY MANAGEMENT AGENCY Expiration Date: July 31, 2015 National Flood I rance Program IMPORTANT: Follow the instructions on pages 1-9. ill Job#: 13-157D SECTION A — PROPERTY INFORMATION kFOR`INSURANGE COMPANY USES Al. Building Owner's Name Seminole Mobile Park LLC PollCy rvumbe A2. Buildir) Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number x 3,,,918 Orange Park Avenue, lot 61 city Flt. Pierce State Fl ZIP Code 34947 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 240$�243-0003-000-6, Lot 61 A4. Buildi'g Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential t A5. Latitude/Longitude: Lat. 77 4477 N Long. 80,3603 W Horizontal Datum: ❑x N , NA 1 A6. Attach, at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. t A7. Buildi.ig Diagram Number 5 �' A8. Fora uilding with a crawlspace or enclosure(s): A9. For a building with an attached garage; a) S416are footage of crawlspace or enclosure(s) N/A sq ft a) b) NQ of permanent flood openings in the crawlspace or b) Square footage of attached garage N/A sq ft Number flood in, en,Iclosure(s) within 1.0 foot above adjacent grade 0 of permanent openings the attached garage within 1.0 foot above adjacent grade g c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b NIA sq in d) En"gineered flood openings? ❑ Yes ®No d) Engineered flood openings? ❑ Yes ®No III SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number St. L'bcie Countv Unincorporated Areas 120285 B2. County Name St. Lucie B3. State I Florida B4. Map Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone 1�11 Revised Date AO, use base flood depth) 121 CO178 J 02/16/2012 02/16/2012 A N/A B10.Indicate the source of the Base Flood -Elevation (BFE) data or base flood depth entered in Item 69: ❑ Fib Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No 11 Designation Date: / / ❑ CBRS ❑ OPA 11 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Builo-ing elevations are based on: ® Construction Drawings* ❑ Building Under Construction* *A Elevation Certificate ❑ Finished Construction new will be required when construction of the building is complete. C2. EleJations — Zones Al—A30, AE, AH, A (with BFE), VE, VI—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO. Complete Items C2. �° h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Belchmark Utilized: "LURE" Vertical Datum: 20.385' NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 Da '� m used for building elevations must be the same as that used for the BFE. ❑ Other/Source: Check the measurement used. a) Pp of bottom floor (including, basement, crawlspace, or enclosure floor) 21 8' ® feet ❑ meters b) I�lI�op of the next higher floor N A ® feet ❑ meters c) sottom of the lowest horizontal structural member (V Zones only) N A ®feet El meters d) Ilpttached garage (top of slab) N A ® feet ❑ meters e) 'lowest elevation of machinery or equipment servicing the building N A ® feet ((,Describe ❑ meters type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 18 6 ® feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 18 , 8 ®feet El meters', h) Lowest adjacent grade at lowest elevation of deck or stairs, including N A ®feet ❑meters structural support This infon I and (] Cr ❑ Cr Cert will Title lit SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION cation is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation i. I certify that the Information on this Certificate represents my best efforts to interpret the data available. id that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ere if comments are provided on back of form. Were latitude and longitude in Section A provided by a ere if attachments. licensed land surveyor? ® Yes ❑ No Name E. H� 445 9th Street SW, IJ I 't 7 Signatue it FEMA FgIrn 086-0-33 (7/12) License Number 4416 Company Name Hayhurst Land Surve in , Inc. City State ZIP Code Vero Beach FI 132962 Date /o jgXj Telephone I (772) 569-6680 See reverse side for continuation. -4416- Replaces all previous editions. ELEVATION CERTIFICATE, page 2 i IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR'IN5UR1kNCE COMPANY USES i Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O..Route and Box No. Pol cy"Number 3318 Orange Park Avenue, lot 61 City State ZIP Code Col<lpahyNAICNumber r `,, Ft. Pierce FI 34947 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this:Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. s+;; ;Comments First floor elevation represents a proposed structure to be placed on the site Signature SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A; B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. 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) Top 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 8-9 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. 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 flocdplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. 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 William E, Hayhurst Address 445 9th Street SW, Unit 7 city Vero Beach State FI ZIP Code 32962 Signature Date Telephone (772) 569-6680 Comments I ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodpiain management ordinance can complete Sections A, B, C (orI1E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used 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 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—G9) is provided for community fioodplain management purposes. G4. Permit Number I G5. Date Permit Issued G6. Date Certificate Of Compliance/Occucancv Issued I G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement 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. G10.Community's design flooa elevation: ❑feet ❑ meters Datum II Local Official's Name l Title I'il I Community Name Signature Comments Telephone Date ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions.