HomeMy WebLinkAboutPOST CONSTRUCTION ELEVATION CERTIFICATE�i':..,- ---- — — -- — —- OMB 026-R-OD026
` "rE'7 1. EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
-,
POST CONSTRUCTION ELEVATION CERTIFICATE/FLOODPROOFING CERTIFICATE
UA• ,46gL) COMMUNITY NUMBER
J
St. LIcie
Co., F1. (UNINCORPORATED AREAS) [B 120285
I.
�8 fl .
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vp_UqJf - IL9 MINSTRUCTIONS
The register?d
professional engineer, architect, surveyor or community permit official completes Section I below.
Section II may
be completed by any of the professionals listed at the beginning of Section II, or by a similarly qualified
local permit ol1t�icial.
Print or type the information on this form. This form is to be used for new (POST -FIRM) construction
and for substlantial
improvements to existing structures in Zones Al-A30, AH and V1-V30 and existing (PRE -FIRM)
- buildings to d;e
II
rated under POST -FIRM rules and rates.
SECTION I
(TO BE COMPLETED BY COMMUNITY PERMIT OFFICIAL)
'ROFERTY ADDRESS (or lot and block numbers if address is unavailable) Owner:— Edward & Marie Blum
lm 5514 Parive INDIAN RIVER. ESTATES (NAME: Edward A. Blum, Inc. BP# 50996 )
9A MAP PANEL ON 4
HICH PROPERTY IS LOCATED
FIA MAP ZONE IN WHICH PROPERTY IS LOCATED
0281B Ill
AH
IA MAP EFFECTIVE D�TE
Janua4, 5,
BASE FLOOD ELEVATION AT THE PROPOSED SITE
1984
17
;TART OF CONSTRU
;ION DATE
Name and Title
PHONE (with Area Code)
10/89 I'
Terry L. Virta—Community Develo ment Direc
0 —
'iDDRESS
23.0.0_y.Jrginia
Ave,, Ft, Pierce, F1. 33450
i
10/24/89
Date
SECTION II
INSTRUCTIONS
Complete only,
the Elevation Certification unless the building has been floodproofed at least to the base flood
elevation. If f�oodproofing
is used, complete only the Floodproofing Certification. The Elevation Certification may be
completed by
a registered professional engineer, architect, or surveyor. The Floodproofing Certification may only be
completed by
registered professional engine.er or architect.
ill •
ELEVATION GEH l`IFICA I ION
I certify that
t u Iding at the property location described above has the lowest floor at an elevation of
2 0.5
p feet, NGVD (mean sea level). ( 2 0. 0 Garage) '
!I
I ,
F LOODPROOFING CERTIFICATION
I certify to t 'e best of my knowledge, information, and belief,' that the structure is designed so that the structure is
watertight to n elevation of feet NGVD (mean sea level), with walls substantially
impermeable toI the passage of water and structural components having the capability of resisting hydrostatic and
hydrodynamic Ilpads and effects of buoyancy that would be caused by the flood depths, pressures, velocities, impact
and uplift force associated with the base flood.
In the event of looding, will this degree of floodproofing be achieved with human intervention?*
I�
•
Will the structu II be occupied as a residence?
If the answer td both questions is Yes, the floodproofin cannot be credited for rating purposes and the elevation
9 9 P P
certification mu t be completed instead.
II
Floodproofed w11 ith human intervention means that water will enter the structure when floods up to the base flood
level occur, unl,' ss measures are taken prior Jo the flood to prevent entry of water (e.g. bolting metal shields over
doors
and wind Iws).
'ERTIFIER'S NAME
III
AFFIX SEAL OR WRITE PROFESSIONAL
E. ' Brett
Clulpepper
LICENSE NO. BELOW:
ITLE
Registeredl'ILand
Surveyor
,DDRESS
Culpepper
�61, Terpening, Inc.
P.O. Box
1, 4 9
Ft. PIerce
FL 34954
12/28/89
�! (signature) (Date)
The insura4
agent attaches the second copy of the completed form to the flood insurance policy application
for new (PO8T•FIRM)
construction or substantial improvements. Be sure. that the second copy is certified. -