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HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DEPARTMENT OF HOMELAND SE.' -=;ITY Federal Emergency Management Agenq National Flood Insurance Program IMB No.1660-0008 Expiration Date: November 30, 2018 ELEVATION CERTIFICATE Important Follow the Instructions on pages 1- 9. Copy all pages 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. Building Owners Name Policy Number. Nick & Lillian Ewen A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 3244 River Drive City State ZIP Code Fort Pierce Florida 34981 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12, RIVER OAK ESTATES (PLAT BOOK 16, PAGE 5) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat.27.404028'N Long.80.372773°W Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1B A8. For a building with a mawlspace or endosure(s): a) Square footage of crawlspace or enclosure(s) WA sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade WA c) Total net area of flood openings in AB.b WA sq in IJI d) Engineered flood openings? ❑ Yes 0 No AS. For a building with an attached garage: V^ ry a) Square footage of attached garage 650.00 sq It b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade WA c) Total net area of flood openings in A9.b N/A sq in d) Engineered 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 County-120285 St. Lucie Florida B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel Flood B9. Base Flood Elevation(s) Date Effective/ es) (Zone AO, use Base Flood Depth) Revised Date [AE� 12111CO188 J 02-16-2012 02-16-2012 12.0 Feet B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Forth 086�33 (7115) Replaces all previous editions. Form Page 1 of 6 SC'ByIV4 -UCIe col ELEVATION CERTIFICATE OMB No. 1660-0008 Elr ira6n. reJe: u,. ...b on nnJn IMPORTANT: 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. 3244River Drive - - CRY State ZIP Code Company NAIC Number Fort Pierce Florida 34981 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' x❑ Building Under Construction` ❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Al-A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a=h below according to the building diagram specified in Item AT In Puerto Rica only, enter meters. Benchmark Utilized: St Lucie BM QUAIL, elev.=14.26' Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. . ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: Datum 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) 12.3 ❑x feet ❑ meters b) Top of the next higher floor 21.0 x❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 11.0 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 9.9 Ej feet ❑ meters f) Lowest adjacent (finished) grade next to building (LAG) 9.6 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 9.9 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 9.6 ❑x feet ❑ meters SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifiration is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Cedificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine orimprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes []No ❑ Check here if attachments. Certfier's Name License Number '�_°'�t P. Chad Maxwell LS 7070 r'• _ 9 p % A Title Professional Land Surveyor y Company Name Maxwell Geospatial, Ina Address 565 39th Court SW . �.4ti "J `l.. `o •�i +:•!-�1'.,; air - .'<<•` i City State ZIP Code Vero BeachFlorida 32968 ti A'•rAFra' Signature to Telephone Ext. 'JJJaIJJ"' , qD (772) 925-1060 Copy all pages of this Elevation Certificate and all attachments for 1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) The scope of this Elevation Certificaje is limited to the building addition under construction. A5: Google Maps _ C2(e): Pool Equipment; A/C units and Generator elevated above BFE - see photo 2 FEMA Form OBM-33 (7/15) - Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE AB No.1660-0008 �Y.nim inn rlatp- Nnvpmhor An grist IMPORTANT: 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: 3244 River Drive .city - --State— - ZIPCodeCompany NAIC Number Fort Pierce Florida 34981 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items EII—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6� with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1 2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Tap of platform of machinery and/or equipment servicing 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 floodplain 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 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. Property Owner or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Forth 086.0-M (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE ,AB No.1660-0008 r:nimfinn nMa- Nnvomhor'in 9nin IMPORTANT: 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: 3244 River Drive - -City- - - - - - - - -state- ZIPCode- Company NAIC Number Fort Pierce Florida 34981 SECTION G -COMMUNITY INFORMATION (OPTIONAL) The local official 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 Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items 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 bylaw 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. Permit Number G5. Date Permit Issued G6. Date Certificate of Complianoo/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), If applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 4 of 6 - UILDING PHOTOGRAPHS IB No. 166o 000a ELEVATION CERTIFICATE See Instructions for ItemA6. �x n..e-u....e..k—qn.,,,,o Policy Number. r Company NAIC Number WHIII It il.Alp{ st . .1YYYI-r+Ae.. Xe •#tea, �'4?k•°C.afihml�43,..6�� w ": ¢, V` �t.w.. °z,"'ir }"'.fb�� ,:`k-ri$ rtnnA ronn uuo-w33 (7/15) Replaces all previous editions. Form Page 5 of 6 W.S. DEPARTMENT OF HOMELAND SE - TY / / OMB No. 1660-0008 ,Fedira Emergency Management Agency Expiration Date: NoverMEM 2018 National Flood Insurance Program FEB.$ 51010 ELEVATION CERTIFICATE Pennk1.0 ecounDeparoent Important: Follow the instructions on pages 1-9. � �u�e County Copy all pages 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. Building Owner's Name ' Policy Number. Nick & Lillian Ewen A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Num er: Box No. 3244 River Drive CANNED city State ZIP ode St. �U Fort Pierce Florida 34981 c�e COUI) A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12, RIVER OAK ESTATES (PLAT BOOK 16, PAGE 5) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat 27.404028°N Long.80.372773'W Horizontal Datum: ❑ NAD 1927 © NAD 1983 A6. Attach at least 2 photographs of the building 'rf the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 18 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes Z No A9. For a building with an attached garage: a) Square footage of attached garage N/A sq It b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? [—]Yes ❑ No SECTION B= FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State St. Lucie County -120285 St. Lucie Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12111CO188 J 02-16-2012 02-16-2012 AE 12.0 Feet B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item Bg: ❑ FIS Profile. Z FIRM ❑ Community Determined ❑ Other/Source: B71. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 Z NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Z No Designation Date: ❑ CBRS ❑ OPA Pr MG Fnrm nRRJL13 171M Rnnlorec III nmvinuc =r i4inne Gnrm Donn 1 of r °ELEVATION CERTIFICATE )MB No.1660-0008 xpiration Date: November 30, 2018 IMPORTANT: 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. 3244 River Drive City State ZIP Code Company NAIC Number Fort Pierce Florida 34981 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* 0 Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations —Zones Al—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 A30, AR/AH, AR/AO. . Complete Items C2.afi below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: St Lucie BM QUAIL, elev.=14.26' Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: Datum 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) 12.3 0 feet ❑ meters b) Top of the next higher floor 21.0 0 feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A .❑ feet ❑ meters d) Attached garage (top of slab) N/A ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building g,9 0 feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 9.6 0 feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 9.9 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 9.6 0 feet ❑ meters structural support SECTION D —SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. l certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine, or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number P. Chad MaxwellLS 7070 Title Professional Land Surveyor Company Name Maxwell Geospatial, Inc. Address 565 39th Court SW y� 21 City State ZIP Code Vero Beach Florida 32968 % 7 Signature Datp Telephone Ext. z [Z ?yam (772)925-1060 Copy all pages of this EI vation Certificate and all attachments for ( ) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) The scope of this Elevation Certificate is limited to the building addition under construction. A5: Google Maps C2(e): Pool Equipment; A/C units and Generator elevated above BFE - see photo 2 ¢nnA r....., noc n_aq nil M oe. 1­-11 ...e 4— _A;+; . Form Paoe 2 of 6 'ELEVATION CERTIFICATE )MB No. 1660-0008 xpiration Date: November 30, 2018 IMPORTANT: 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. 3244 River Drive City State ZIP Code Company NAIC Number Fort Pierce Florida 34981 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BEE) For Zones 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. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, 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/or9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing 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 floodplain 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 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. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. -ELEVATION CERTIFICATE IDMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: 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. 3244 River Drive city State ZIP Code Company NAIC Number Fort Pierce Florida 34981 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official 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 Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in items 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, pndicate 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 floodplaini management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑feet ❑meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: _ ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. ter-... I__ ............ _n _._..:,... -A.4:....- Fnrm pan. d of R BUILDING PHOTOGRAPHS OMB No. 1660-0008 • ELEVATION CERTIFICATE See Instructions for Item AS. Expiration Date: November 30, 2018 IMPORTANT: 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. 3244 River Drive City State ZIP Code Company NAIC Number Fort Pierce Florida 34981 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View", and, if required, "Right Side View" and "Left Side `few." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. - y.f ti INN G [ i Photo One Photo One Caption FRONT VIEW-2113/2020 ClearP otoOne_,; J C'I Yr� g9w Xt �� *' S }}''4 i Y ,�� Photo T.. Photo Two Caption Mechanical Equipment-10/1/2019 Clea[ Pho{o,„Two_, FFnnn F„",n nartin-zq 171191 Runlnroe .II rlfinn. 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