HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DES ll RTMENT OF HOMELANDS'-••JRITY OMB No. 1660-0008
Federal •E ergency Management Agenc_; _, SCANNED � Expiration Date: November 30, 2018
National FI od Insurance Program BY
ELE�IXIT1 4 ERTIFICATE
Important: Follow the instructions on pages 1-9.
�I
Copy all p es 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
Al. Bui'
ing Owner's Name
Policy Number:
PAUL & JANE MESSENGER
A2. Bui'I
ing Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Bo
No.
10851 SOUTH OCEAN DRIVE, #30
Ci State ZIP Code
JE, SEN BEACH Florida 34957
A3. Pr
iperty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
P 1 D
4511-8.10-0037-000-6
A4. Budding Use (e.g., Residential; Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. La Rude/Longitude: Lat. 27015'59.25" N Long. 80°12'21.59" W Horizontal Datum:. ❑ NAD 1927 ❑X NAD 1983
A6. A each at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Bu Iding Diagram Number 8
A8. Foil a building with a crawispace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 1,097 sq ft
b) umber of permanent flood openings in the craw ispace or enclosure(s) within 1.0 foot above adjacent grade 6
c) otal net area of flood openings in A8.b 768 sq in
d) Engineered flood openings? ® Yes ❑ No
A9. Fo a building with an attached garage:
a) j Square footage of attached garage na sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade na
c) Total net area of flood openings in A9.b na sq in
d) Engineered flood openings? ❑ Yes No
f
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NI
1P Community Name & Community Number
B2. County Name
B3. State
ST. LL
CIE COUNTY, UNINCORPORATED 120285
ST. LUCIE
FL
B4. Ma'/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s)
N
ber
Date
Effective/
Zone(s)
(Zone AO, use Base Flood Depth)
Revised Date
12111'1
C0314
J
2-16-12
2-16-12
AE
7.0
B10.
ndicate the source of the' Base Flood Elevation (BFE) data or base flood depth entered in Item 69:
FIS Profile ❑X FIRM ❑ Community Determined ❑ Other/Source: na
B11.
ndicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑X NAVD 1988 ❑ Other/Source: na
B12. Is
the building located in.a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: na ❑ CBRS ❑ OPA
.. FEMA Jorm 086-0-33 (7/15) Replaces all previous editions. Form Pagel of 6
ELEVX ION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORT
I' T: 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:
10851 SOUTH OCEAN DRIVE, #30
City
State ZIP Code
Company NAIC Number
JENS
N BEACH Florida 34957
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Bu
on: Construction Drawings* Building Under Construction* X Finished Construction
ding elevations are based ❑ 9 ❑ ❑
*A
ew Elevation Certificate will be required when construction of the building is complete.
C2. EIE
ations — 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.
CoFmark
lete items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Be
Utilized: L-NET Global Navigation Satellite System Vertical Datum: NAVD 1988
Indicate
elevation datum used for the elevations in items a) through h) below.
[i❑ NGVD 1929 -❑X NAVD 1988 ❑ Other/Source: na
Da
m 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) 3.8 ❑X feet ❑ meters
b)
Top of the next higher floor 8.85 ❑X feet ❑meters
c)
Bottom of the lowest horizontal structural member (V Zones only) NA ❑feet ❑meters
d)
Attached garage (top of slab) NA ❑ feet ❑ meters
e)
Lowest elevation of machinery or equipment servicing the building 8.13 ❑X feet ❑ meters
(Describe type of equipment and location in Comments)
f)
Lowest adjacent (finished) grade next to building (LAG) 3•8 ❑X feet ❑ meters
g)
Highest adjacent (finished) grade next to building (HAG) 4.2 X❑ feet ❑ meters
h)
Lowest adjacent grade at lowest elevation of deck or stairs, including 4.1 ❑X feet ❑ meters
structural support
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This c
ification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
I cert'
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 Ititude
I,
and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No ❑ Check here if attachments.
Certifi
Alex
s Name License Number
nder J. Piazza #6330
D AT �1' 22,
,P":.
Title
Pres
ent
'- 831 v
Comp
ny Name
Alex
nder J. Piazza PSM, Inc.
_
NA
Address
619
W Biltmore Street
j ,-f"`'-•`�L .t�..
FL,y 1=tyT}`#s33o
City
State ZIP Code3°.Q"
34983
Port,lSt.
Lucie Florida
Signa'
re Date Telephone Ext.
1-21-19 772-340-7770
Copy 'tl
pages o his Elev n nd all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Com
(including type of equipment and location, per C2(e), if applicable)
IFnts
MACHINERY
SERVICING THE BUILDING IS AN AIR CONDITIONING UNIT LOCATED ON THE
NOR
H SIDE OF THE BUILDING.
The Q
MART vents (Model FFNF08) openings are 128 sgin/each and can cover 220sf of covered area
each.l,
6 vents = 1,320sf covered area total.
FEMA I!orm 086-0-33 (7/15) Replaces all previous editions. corm rage z b or
,II
tLEVA ION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTA,
T: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building
c Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
�reet
10851 SOUTH OCEAN DRIVE, #30
City
State ZIP Code
Company NAIC Number
JENS
TIN BEACH Florida . 34957
SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zonei AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete 3ections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter met irs.
E1. Prov Je elevation information for the following and check the appropriate boxes to show whether the elevation is above or below
the f }ghest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) T p of bottom floor (including basement,
wlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) p of bottom floor (including basement,
wlspace, or enclosure) is ❑ feet, ❑ meters ❑ above or ❑ below the LAG.
uilding Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions),
E2. Foril!xt
the higher floor (elevation C2.b inthe
agrams) of the building is ❑ feet ❑ meters ❑above or E] below the HAG.
E3. Atta hed garage (top of slab) is []feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top'' f platform of machinery and/or equipment
se cing the building is []feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zon AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floo 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 pro46rty
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.
Prope
!Owner or Owner's Authorized Representative's Name
Address
City State ZIP Code
Signatui
Date Telephone
Comme 'Its
I
❑ Check here if attachments.
FEMA 16rm 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
FLFVA ON
CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTA
T: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building S
reet Address (including. Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
10851 SOUTH OCEAN DRIVE, #30
City
I State ZIP Code
. Company NAIC Number
JENS
BEACH 'Florida. 34957
SECTION G — COMMUNITY INFORMATION (OPTIONAL)
The local
fficial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sections
, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement
used in It
ims 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 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. Pe
it Number
G5. Date Permit Issued
G6. Date Certificate of
Compliance/Occupancy Issued
G7. Thi
permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. EI
ation of as -built lowest floor (including basement) ❑ feet ❑ meters Datum
oft
a building:
G9. BF
or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. Col
munity's design flood elevation: ❑ feet ❑ meters Datum
Local Of
cial's Name Title
Commul
ity Name Telephone
Signatu
Date
Comme
Its (including type of equipment and location, per C2(e), if applicable)
i
•
❑ Check here if attachments.
FEMA I,prm 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6
1=LFVATION
BUILDING PHOTOGRAPHS. OMB No. 1660-0008
CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018
IMPORTA
O T: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building
S reet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
10851 SOUTH OCEAN DRIVE, #30
City
State ZIP Code
Company NAIC Number
JENSE
BEACH Florida 34957
If using
li he Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instruct;
s for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and
examples of the flood openings or
"Left Side
View." When applicable, photographs must show the foundation with representative
vents, a$
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
.
i -
a1
17
iS,
Photo One
Clear Photo One
Photo One Caption Front VI@W
2..0 .
C 1'Fcti.�A +; U '
�—
r
Photo Two
Photo
wo Caption Back View Clear Photo Two
FEMA ,orm 086-0-33 (7/15) Replaces all previous editions. Form Page b of b
ELO-V AT ON
BUILDING PHOTOGRAPHS
CERTIFICATE _J Continuation Page
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTA
111
: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building S
eet Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
10851 SOUTH OCEAN DRIVE, #30
City
State ZIP Code
Company NAIC Number
JENSE
', BEACH Florida 34957
If submi
Ing more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: dat'
taken; "Front View" and 'Rear View'; and; if required, 'Right Side View" and "Left Side .View." When applicable,
photogra
hs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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Photo T �ee
Caption Vent View (Typical) :Cleacl?l oto TF ree.
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Photo Four
Photo lour
Caption Vent Info Cleat Photo Four
FEMA Jrm 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6