Loading...
HomeMy WebLinkAboutELEVATION CERTIFICATEd ELEVATION CERTIFICATE ��� � avk U.S. DERA, �MEKT. F HOMELAND SECURITY FEDERAL �MERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 Nalional F od Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Builli ing Owner's Name Keara and William Goulet - Garage Apt. Policy Number: A2. Bui ing Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 2305 Atl ntic Beach Boulevard C1 '1 Fort Pierce State FL ZIP Code 34949 ry �* is � w e � i , A3. Pr" erty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) J P,1U�u�l� u� Lot 12, Block 35, Revised Plat of Fort Pierce Shores Unit 5, PB 9, PG 36, Saint Lucie County, FL 591 y A4. Bu:ding Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential St, 'Lude �. wfflk` A5. La tude/Longitude: Lat. 27deg 28min 42.12secN Long. 80deg 17min 47.16secW Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. At ch at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Bui ding Diagram Number 1A A8. Foa building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) NA sq ft a) Square footage of attached garage NA sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage jor enclosure(s) within 1.0 foot above adjacent grade NA within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b NA sq in d) Engineered flood openings? El Yes El No d) Engineered flood openings? El Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. N P Community Name &Community Number B2. County Name 63. State St. Lu a County 120285 Saint Lucie County Florida B4. ap/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 2111CO181 J 02/16/2012 Effective/Revised Date Zone(s) AO, use base flood depth) 02/16/2012 X NA B10. 11 "' icate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. 1 dicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: I B12. I the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date: ❑ CBRS ❑ OPA II [1 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. B �' ilding elevations are based on: ® Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction * new Elevation Certificate will be required when construction of the building is complete. C2. E 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. Complete Items C2.a-h b low according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. BI' nchmark Utilized: See Comments Vertical Datum: NAVD 1988 1 icate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: tum 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) 8.10 ® feet ❑ meters b Top of the next higher floor 18.83 ® feet ❑ meters c Bottom of the lowest horizontal structural member (V Zones only) N.A ❑ feet ❑ meters Attached garage (top of slab) N.A ❑ feet ❑ meters ' Lowest elevation of machinery or equipment servicing the building N.A ❑ feet ❑ meters (Describe type of equipment and location in Comments) f Lowest adjacent (finished) grade next to building (LAG) 7.80 ® feet ❑ meters Highest adjacent (finished) grade next to building (HAG) 7.90 ® feet ❑ meters fiI Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 8.10 ® feet ❑ meters SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Thi certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation.,,""I infolImation. i certify that the information on this Certificate represents my best efforts to interpret the data available. I u Zstand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001 ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a,'" ❑ it Check here if attachments. licensed land surveyor? ® Yes ❑ No Ce"ifier's Name Ernesto Velasco, P.E License Number 35649 N Tit; Professional Engine Company Name Velcon Group, Inc. AdI'Idress 702 SW Port S cie Blvd City Port St Lucie State FL ZIP Code 34953 gnature Date 12/07/2015 Telephone 772 879 0477 Form 086-0-33 (7/12 See reverse side for continuation. Replaces all previous editions. V VL.rr�l �ll'v Ir VVI�1.I - IL, FJ uw- IMPOkT1 NT fn these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building reet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 2305 Atla' tic Beach Boulevard City Fortl ierce State FL ZIP Code 34949 Company NAIC Number: SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy botf sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Commen C2 - Benchmark Utilized is St. Lucie County Benchmark'A-27'Vertical Monumentation'F.D.N.R' having a published elevation of 5.85 NAVD 1988 Section D - Lattitud ngitu de rmined by measure from Geo- Referenced Digital Ortho Signatur Date 12/07/2015 SEC 1ION E — BUILDI G ELE ATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. F ,'r Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Pro ide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent gra a (HAG) and the lowest adjacent grade (LAG). a) p of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) p of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. Fori uilding 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 (el(yation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Att shed garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. ToliIl' of platform of machinery and/or equipment servicing the building is ❑ feet Elmeters Elabove or [J below the HAG. E5. Zo 3 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 ord ance? ElYes ElNo E]Unknown. The local official must certify this information in Section G. II SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The prop, rty 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 AIi must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property wner's or Owner's Authorized Representative's Name Address City State ZIP Code Signatur Date Telephone Commen ❑ Check here if attachments. I I SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local d icial 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 Elev tion Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ he information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who i authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. C3. ❑ the following information (Items G4—G10) is provided for community floodplain management purposes. G4. Perrrt Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 67. This ermit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elev ion of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFEi r (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Com unity's design flood elevation: ❑ feet ❑ meters Datum Local Off ial's Name Title Commun y Name Telephone II_ 1 11r' 1 Signatur4i Date a AA C V`J u V Check here if attachments. FEMA Fd, m 086-0-33 (7/12) Replaces all previous editions.