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Home My WebLink AboutELEVATION CERTIFICATEi U.S. DE RTMENT OF HOMELAND SEC'.,_ -,TY �� 'OMB No. 1660-0008 Federal 0 mergency Management Agency o I Expiration Date: November 30, 2018 National F od Insurance Program M Udoccon i ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pges of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Bu ding Owner's Name Policy Number: D.R. H RTON (ding A2. Bu Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Bo' No. 8712 C BBLESTONE DRIVE City State ZIP Code FO, T PIERCE Florida 34945 A3. Pr iperty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 2326-6 0-0061-000-4 lot 56 A4. Bu ding Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. La i ude/Longitude: Lat. 27°24'37.94" N. Long. 80°24'54.15" W. Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Att ch at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. Foii a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) lumber of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) otal net area of flood openings in A8.b N/A sq in d) i ngineered flood openings? ❑ Yes ❑X No A9. For 3 building with an attached garage: a) quare footage of attached garage 400.00 sq ft b) lumber of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) otal net area of flood openings in A9.b N/A sq in d) 11,, ngineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFI Community Name & Community Number B2. County Name B3. State St. Lucie County 120285 Saint Lucie Florida B4. Map/Panel anel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Num er Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) i Revised Date 12111 C0 70 I J 02-16-2012 02-16-2012 AE 16.5 B10. Inii irate 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. In icate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ❑X NAVD 1988 ❑ Other/Source: i B12. Is I the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA i FEMA FoO 086-0-33 (7/15) Replaces all previous editions. Form Pagel of 6 I ELEVP ION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORT,, NT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8712 cc BLESTONE DRIVE City State ZIP Code Company NAIC Number FORT P RCE Florida 34945 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. B �Iding elevations are based on: ❑ Construction Drawings* x❑ Building Under Construction* ❑ Finished Construction *A' iew Elevation Certificate will be required when construction of the building is complete. C2. El vations — 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. C I nplete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. B I�chmark Utilized: AF6653 Vertical Datum: NAVD 88 In sate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: D um 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) 18.44 ❑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) 17.84 x❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building N/A ❑ feet ❑ meters ((Describe type of equipment and location in Comments) f) 1 Lowest adjacent (finished) grade next to building (LAG) N/A ❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) N/A ❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ feet ❑ meters (structural support N/A SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This ce° ification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. l certi j�that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statem nt may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were I �itude and longitude in Section A provided by a licensed land surveyor? ❑x Yes El No ❑Check here if attachments. Certifie s Name License Number Thoma P. Kiernan 6199 ,� BPS F�Q,L•. ••Nu•be• Title Profess onal Surveyor � O,. e• 9 ' Compa iy Name Culpep Jer & Terpening. Inc. II ..-07. T of l •i�Q o Addres ' 2980 S uth 25th Street •. •��s`�% •:�[��ktm;:• �; ••IIYY.. • '',, �au11e' a, City State ZIP Code Fort Pi �tce Florida 34981 Signatu'e Date Telephone Ext. J/ ZG/J19(772) 464-3537 206 Copy all' ages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comme'II is (including type of equipment and location, per C2(e), if applicable) i i i i FEMA Fo�` 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEV4TION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORT��, NT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building''Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8712 C �BBLESTONE DRIVE City State ZIP Code Company NAIC Number FORT P RCE Florida 34945 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zon Is AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complet Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter me eters. E1. Pro hide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the d ighest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) lop of bottom floor (including basement, rawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) op of bottom floor (including basement, rawlspace, 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 1-2 of Instructions), the ', ext higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑below the HAG. E3. Atta hed garage (top of slab) is 0 feet ❑ meters ❑ above or ❑ below the HAG. E4. Topiof platform of machinery and/or equipment se I crag 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 floo I plain 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 communii y-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 Address City State ZIP Code I Signatur Date Telephone Commer s I� ❑ Check here if attachments. FEMA Fof'�n 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVAA,TION CERTIFICATE UMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORT„ NT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building �treet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 8712 C i�BBLESTONE DRIVE City State ZIP Code Company NAIC Number FORT P RCE Florida 34945 a SECTION G — COMMUNITY INFORMATION (OPTIONAL) The loc official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in ems 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. Per it Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. Thi permit has been issued for: E]New Construction ❑Substantial Improvement G8. EI v ation of as -built lowest floor (including basement) of i a building: E]feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Co munity's design flood elevation: ❑ feet ❑ meters Datum Local O 1 cial's Name Title Commu 'ty Name Telephone Signatur Date Comme s (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Forim 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 1.___jUILDING PHOTOGRAPHS �--6MB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018 IMPORT NT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building ',Street 8712 C I,BBLESTONE Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. DRIVE Policy Number: City I FORT P State ZIP Code RCE Florida 34945 Company NAIC Number If usin4 instruct "Left Site vents, is the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the ns for Item A6. Identify all photographs with date taken; "Front View" and "Rear View'; and, if required, 'Right Side View" and View." When applicable, photographs must show the foundation with representative examples of the flood openings or indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. II Photo One Photo Or Caption Front ; Clear Photo One . I �I I i i Photo Two Photo Tw 'i Caption Back i, Clear Photo Two FEMA ForrYt 086-0-33 (7115) Replaces all previous editions. Form Page 5 of 6 • I ELEVP TION �UILDING PHOTOGRAPHS CERTIFICATE Continuation Page OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORT, NT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building 8712 CC! treet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. BBLESTONE DRIVE Policy Number: City FORT P State ZIP Code RCE Florida 34945 Company NAIC Number If subrr,tting with: d photog more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs to taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and "Left Side View." When applicable, phs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. I i I I I i i Photo Three Photo T ee Caption Right Side [,Clear Photo Three I i I I i I I i I I i I Photo Four Photo Fo' r Caption Left Side j,'Clear.Phot'oTmr FEMA Fo�,� 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6