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HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DE RTMENT OF HOMELAND SECURITY SCANNED Federal mer enc Management Agency Q� OMB No. 1660-0008 9 Y 9 Y St. LweG®uq1{r�I Expiration Date: November 30, 2022 National I od Insurance Program �i� ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all p ,ges of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/companv, and (3) buildina owner. III SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Bui ing Owner's Name Policy Number: I Ve ietian Administration, LLC A2. Builli ing Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and BoNo. x Company NAIC Number: 441 N Highway A1A City' State ZIP Code Fort Ierty ierce Florida 34949 A3. Pro Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot , Block A, Queens Island Preserve, Recorded in PB 60 PG 4, St Lucie County, FL A4. Buil l ng Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latin de/Longitude: Lat. 27D 30M 54.03S N Long. 80D 18M 29.03S W Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Atta at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Build g Diagram Number 1 B 6 A8. For building with a crawlspace or enclosure(s): a) S uare footage of crawlspace or enclosure(s) 0.00 sq ft b) N ber of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0 c) To I net area of flood openings in A8.b 0.00 sq in d) E I ineered flood openings? ❑ Yes ❑x No A9. For a uilding with an attached garage: a) Sq are footage of attached garage 0.00 sq ft b) Nu ber of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Tot I net area of flood openings in A9.b 0.00 sq in d) En ' I neered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State St. Lucie C unty 120285 St. Lucie County Florida B4. Map/Pa Number l B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood B9. Base Flood Elevation(s) Zone(s) (Zone AO, use Base Flood Depth). Revised Date 12111CO0931 K 02-19-2020 02-19-2020 X & VE 11 1310. Indica the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FI Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indica# elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: 612. Is the uilding located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Desig tion Date: ❑ CBRS ❑ OPA FEMA Form 08 -0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 i ELEV ,,, TION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPOR1js�14NT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE BuildingStreet I Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 44) 6 N Highway A1A City State ZIP Code Company NAIC Number Fort Pie Florida 34949 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. B Iding elevations are based on: ❑ Construction Drawings* ❑x Building Under Construction* ❑ Finished Construction *A lI ew Elevation Certificate will be required when construction of the building is complete. C2. El Ibations — 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. Col plete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Be chmark Utilized: NGS N 633 Elev 5.33 Vertical Datum: NAVD 1988 Ind to elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Dat m used for building elevations must be the same as that used for the BFE. Check the measurement used. a) op of bottom floor (including basement, crawlspace, or enclosure floor) 13.0 ❑x feet ❑ meters b) op of the next higher floor 24.0 ❑ feet ❑ meters ottom of the lowest horizontal structural member (V Zones only) 22.0 ❑ feet ❑ meters c) Ittached d) garage (top of slab) 9.0 0feet Elmeters e) ipwee st elevation of machinery or equipment servicing the building feet meters x ( escribe type of equipment and location in Comments) N/A ❑ ❑ f) I west adjacent (finished) grade next to building (LAG) 9.0 ❑x feet ❑ meters g) ghest adjacent (finished) grade next to building (HAG) 10.0 ❑x feet ❑ meters h) Ll west adjacent grade at lowest elevation of deck or stairs, including s uctural support 17.9 ® feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certi I Plication is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify th1 t the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statemen jmay be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latit 1 de and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certifier's ame License Number Robert Ke�'� erson, PSM 6285 �� /61� Title Professio 41 Surveyor & Mapper Place Company ame Velcon En ineering & Surveying, LLC Seal Here Address 590 NW P cock Blvd Suite #8 City State ZIP Code Port St Lucll Florida 34986 f J Signature Date Telephone Ext. 05-07-2020 (772)879-0477 Copy all pa s of this Elevate n Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments ncluding type of equipment and location, per C2(e), if applicable) C2 - Bench ark used is a NGS Vertical Control Point "N633" Elev 5.33 NAVD C2(h) - Low 'st Height Structural Member is bottom of pool at 17.90 FEMA Form 0 -0-33 (12/19) Replaces all previous editions. Form Page 2 of 6 ELEVk „TION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPOR ANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE BuildingStreet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 441),6 N Highway A1A City State ZIP Code Company NAIC Number Fort Pie li a Florida 34949 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zon AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complet Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter me ers. E1. Pro' de elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the I�'+ghest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) lop of bottom floor (including basement, crawlspace, or enclosure) is ❑feet ❑meters El above or ❑below the HAG. b) T p of bottom floor (including basement, c awlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For ilding Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the n' xt higher floor (elevation C2.b in the d grams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attac' ed garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top platform of machinery and/or equipment servi ng the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone O only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's flood ain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. �I SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The prope' y ownor owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or communi issueder BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property O ner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments j ❑ Check here if attachments. EMA Form 0 t-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEV TION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORtANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildin , Street Address (including Apt., Unit, Suite, and_/or Bldg. No.) or P.O. Route and Box No. Policy Number: 4 '16 N Highway A1A City I State ZIP Code Company NAIC Number Fort Pi ce Florida 34949 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The loc I 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 injltems 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.) ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) G2 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 E]Substantial Improvement G8. Ele tion of as -built lowest floor (including basement) of t ' building: ❑ feet ❑ meters Datum G9. BF or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Co unity's design flood elevation: ❑ feet ❑ meters Datum Local Offi al's Name Title Communit' Name Telephone II Signature Date Comments', including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 0 6-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6 �I ' I ELEV TION CERTIFICATE BUILDING PHOTOGRAPHS OMB No.1660-0008 See Instructions for Item A6. Expiration Date: November 30, 2022 IMPOR ANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Buildin ' Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 4 6 N Highway A1A City I, State ZIP Code Company NAIC Number Fort Pierce Florida 34949 If usin'Ithe Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instruc, ons for Item A6. Identify all photographs with date'taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left S e View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, s indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. I, i� d ilj� Y ti x q i� 1 sue. P� i ' I 1ji, ,Taken `Photo One Photo On t elCa tion Front View -Date - 05 7-202. p 0 ¢• Clear Photo One lit . )I� F t • I I Photo Two Photo Two C; ption Rear View - Date Taken 05-7-2020 Clear Photo.Two ' FEMA Form 0 6-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6 I C ELEVATION BUILDING PHOTOGRAPHS OMB No. 1660-0008 CERTIFICATE Continuation Page Expiration Date: November 30, 2022 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: 441 N Highway A1A City State ZIP Code Company NAIC Number Fort Pier i Florida 34949 I' If submi ing more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: d t photogri I� e taken; "Front View" and "Rear View"; and, if required,. "Right Side View" and "Left Side View." When applicable, hs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Aa • \� III - '�aL" i11 C"�T�.- � Photo Three- Photo Thril e Caption Right Side View -Date Taken 5-7-20 r - tCleaa Photo Three I it i I I �+ 7 yy\ Photo Four Photo FoulCa tion Left Side View - Date taken 05-7-20 i p C ear Photo Four FEMA For 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 I'