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HomeMy WebLinkAboutELEVATION CERTIFICATEU.S.DEPARTME�ITOFHOMELAND SECURITY OVATION CERIIFIGAIE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 National Flood ranceProgram Important: Read the instructions on pages Ol. Expiration Date: July31, 2015 SECTION A - PROPERTY INFORMATION Al. Building II ers Name WALLY & NAECY BURKE A2. Building „treet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 10701 SOUTH OCEAN DRIVE #841 City JE iSEN BEACH State FL ZIP Code 34957 A3. Property,Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) UAINN LI LOT 841, HO ! IDAY OUT IN AMERICA SECTION D By A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) I'll,Il n g4s (�'�Rago' RESIDENTIAL sue �..-,. A5. Latitude Longitude: Lat. 27.271993 Long. 80.207918 Horizontal Datum: El NAD 1927 0 NAD 1983 A6. Attach all least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 B A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Squre footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) Nu ber of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage ore closure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Tota I net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b � sq in d) Engi'i eered flood openings? ❑Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No l SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Co i munity Name & Community Number B2. County Name B3. State UNINCORP 120285 ST. LUCIE FL B4. Ma p/P nel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111 0314 J 02/16/2012 Effective/Revised Date Zones) AO, use base flood depth) II 02/16/2012 AE 7.0 B10. Indicat �Ithe source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: Bl l . Indicat II elevation datum used for BFE in Item B9: ❑ NGVD 1929 0 NAVD 1988 ElOther/Source: B12. Is the wilding located in a Coastal Barrier Resources System M3RS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Design 'ition Date: _ �] CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) i Cl. Building,, are based on: 0 Construction Drawings* © Building Under Construction' ❑Finished Construction •A new levation Certificate will be required when construction of the building is complete. C2. Elevatio s - 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 arding to the building diagram specified in Item AT In Puerto Rico only, enter meters. Bench ark Utilized: 94 77 A02 RM1 FLDT Vertical Datum: NAVD 88 IndicatePlevation datum used for the elevations in items a) through h) below. El NGVD 1929 0 NAVD 1988 ElOther/Source: Datum sed for building elevations must be the same as that used for the BFE. i Check the measurement used. i a) Top f bottom floor (including basement, crawlspace, or enclosure floor) 7.0 © feet ❑ meters b) Top 'f the next higher floor N/A., El feet El meters c) Bott m of the lowest horizontal structural member (V Zones only) N/A._ ❑ feet ❑ meters d) Atta hed garage (top of slab) N/A., ❑ feet Elmeters e) Low st elevation of machinery or equipment servicing the building N/A_ Elfeet Elmeters (Des gibe type of equipment and location in Comments) 0Low st adjacent (finished) grade next to building (LAG) 4.0 ❑X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.1 feet ❑ meters h) Low,st adjacent grade at lowest elevation of deck or stairs, including structural support N/A._ ❑ feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifi 'l tion is to be signed and sealed by a land surveyor, engineer, or architect authorized bylaw to certify elevation informatio 'I. I certify that the information on this Certificate represents my best efforts to intetpret the data available. 1320-50-01 1 understa ' d that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Che here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 1 PLACE ❑ Che 'here if attachments. licensed land surveyor? 0 Yes El No = ' i H Certifier's ame EARLE R. STARKEY License Number 004459 ' Title PR 1=ESSIONAL LAND SURVEYOR Comp ame ACCURIGHT LAND SURVEYING INC. Addres 1501 DECKER AVENUE ty STUART State . FL ZIP Code 34994 -03/25 LS #"59 Signature Date - Telephone 772-286-7694 FEMA Fo i;; 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 ' IMPORTANT: In these spaces, copy the`r responding information from Section A. Building Street Address (including Apt., Unit, S and/or Bldg. No.) or P.O. Route and Box No. City JENSEN BEACH State FL ZIP Code 34957 . 1riu3p yr r,t s w .. .. . 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. Comments . Signature EARLE R. STARKEY Date 03/25/2014 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 El-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 9See pages 8-9 of Instructions), the next; higher floor (elevation C2.b in the diagrams) of the building is _ _ El 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 ❑ 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's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C'(or E), and G of this Elevation Certificate. Complete the applicable Rem(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-G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued I G6. Date Certificate Of Compliance/Occupancy Issued' 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 flood elevation: _ _ ❑ feet ❑ meters Datum Local Official's Name • . Title Community Name Telephone Signature Date Comments ❑ Check here if attachments.