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HomeMy WebLinkAboutDOCS - RESUBMITTEDSCANNED BY St- Lucie County US. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY National Said [..a Program IMPORTANT: Follow the Instructions on pages 1-9. SECTION A - PROPERTY Al. Building Owner's Name Seminole Mobile Park, LLC A4. A5. A6. A7. A8. or OMB No. 1660A00� Expiration Date: July 31, 2015 Job#: 13-157B FOR INSURANCE COMPANY USE Policy Numher: , Y Ft. Pierce ""` Fl &- "vu7/u3494�- Building Use (e.g., Residential, NonResidential, Addition, Accessory, etc.) Residential Latitude/Longitude: Lat. 27 4477 N Long. RO 3603 W' , Horizontal Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. Building Diagram Number 5 94,)AD For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A ft b) No. of permanent flood openings in the crawlspace or 0 b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade -0 c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b NIA so in d) Engineered flood openings? ❑ Yes N No d) Engineered flood openings? ❑ Yes N No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFlP Community Name & Community Number B2. County Name B3. State St. Lucie CountyUnincorporated Areas 120285 St. Lucie Florida B4. Map/Panel Number B5. Suffix 86. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 12111,0178 1 02/16/2012 02/16/2012 A N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source., B32. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes N No Designation Date: / /- ❑CBRS ❑OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* N Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Ai-A30, AE, AH, A (with BFE), VE, VS-V30, V (with BFE), AR, AR/A, AR/AE, AR/Ai-A30, AR/AH, AR%AO. Complete Items C2.a-h below according to the building diagram specified In Item A7. In Puerto Rico only, enter meters. ' Benchmark Utilized: "LURE" Vertical Datum: 20.385' NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BRIE. Check the measurement used a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 20 9 N feet ❑ meters N A ®feet El meters N A N feet ❑ meters N A Nfeet ❑meters N . A N feet ❑ meters 18 3 N feet ❑ meters 18 . 5 N feet ❑ meters N . A N feet ❑ meters 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. I certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand 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. O Check here if attachments. Were latitude and longitude in Section A provided by a licensed land surveyor? N Yes ❑ No -4416- FEMA Form 086-033 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 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: 3318 Orange Park Avenue lot 49 City State ZIP Code Company NAIC Number: Ft. Pierce FI 34947 SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. _ Comments Signature Date 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 E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. 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 2 4 R feet []meters ® above cr ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is 2' . 6 R feet ❑ meters ® above or ❑ below the LAG. E2. For Building 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 (elevation C2.b in the diagrams) of the building is N A R feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is _AL_ . A R feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _L.. A R 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 flootlplain 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-iss od 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 William E. Hayhurst Address 445 9th Street SW, Unit 7 , city Vero Beach State FI ZIP Code 32962 Signature / / Date a 7 h Telephone r qr/C_ / (772) 569-6680 Comments ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's flootlplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable hem(s) and sign below. Check the measurement used in Items GS-GIO. In Puerto Rico only, enter meters. Gi. ❑ 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.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AD. G3. ❑ The following information (Items G4-G9) is provided for community floodplain 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 FEMA Form 086-0-33 (7/12) ❑ Check here if attachments. Replaces all previous editions. ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. IMPORTANT; In these spaces, copy the corresponding Irdormatlon from Section A. FOR INSURANCE COMPANY USE Building Street Address (Including Apt., Unit, suite, and/or Bldg. No.) or Ra Route and Box No. Policy Number: 3318 Orange Perk Avenue, lot 48 State ZIP Code company NMC Number. Wm T Pie= F1 34947 If usingthe Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below Bccordingto 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 View.' When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AS. If submitting more photographs than will fit on this page, use the Continuation Page. Front (7/30/13) A ..t, I ."s 1. t Side (7/30/13) t � t [A,^ `tilt'-• _ FEMA Form 086-033 (7/12) Replaces all previous editions. I 1 i I � ' I :I f i I ' I i 1• j � I -a r• � � 1 L a r �51 1 1 ! f I li r _ x ' iL - I .i1 { 1 R v „;•° •� �i° s��• rye"'�Y;e`'"1'� 6;.+ ' '�::•3r zSya ri , I I C U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Natimal Fluid lesurance Program IMPORTANT: Follow the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION Al. Building Owners Name Seminole Mobile Park, LLC or OMB No. 1660-0008 Expiration Date: July 31, 2015 Job#: 13-157B FOR INSURANCE COMPANY USE Policy Number City Ft. Pierce state FI zip code 34947 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 2408-243-0003-000-6, Lot 49 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 27 4477 N Long. SO 3603 W Horizontal Datum: 9 NAD 1927 ❑ 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 5 A8. For a building with a crawlspace or enclosure(s): A9. Fora building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawlspace or 0 b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade .0 c) Total net area of flood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? El Yes NNo d) Engineered flood openings? ❑Yes NNo SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number B2. County Name B3. State St. Lucie County Unincorporated Areas 120285 St. Lucie Florida B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/7TA Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AO, use base flood depth) 12111, J 02/16/2012 02/16/2012 N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile N FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source: B12.Is the building located ima Coastal Barrier Resources. System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes N No Designation Date: / /_ ❑CBRS ❑OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* N 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, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified In Item A7. In Puerto Rico only. enter meters. Benchmark Utilized: "LURE" Vertical Datum: 20.385' NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used'for the BFE. a) Top of bottom.floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Check the measurement used. 20 9 ®feet ❑meters N A Nfeet ❑meters N A Nfeet ❑meters N A N feet ❑ meters N . A N feet ❑ meters 18 . 3 N feet ❑ meters 18 . 5 N feet ❑ meters N . A N feet ❑ meters SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the Information on this Certificate represents my best efforts to interpret the data available. 1 understand 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 9 Check here if attachments. licensed land surveyor? N Yes ❑ No Oertifier's Name L License Number -4416- FEMA Form 086.033 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 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 PO. Route and Box No. Policy Number: 3318 Orange Park Avenue lot 49 City State ZIP Code Company NAIC Number: Ft. Pierce FI 34947 SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner._ Comments Date 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 El.-E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B.and For Items Ei-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E3. 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 2 4 ®feet ❑ meters ® above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is Z' .6 ® feet ❑ meters IR above or ❑ below the LAG. E2. For Building 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 (elevation C2.b in the diagrams) of the building is N. A ®feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is JL. A M feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is A ®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) of 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 William E. Hayhurst Address 445 9th Street SW, Unit 7 city Vero Beach State FI ZIP Code a2962 Signature ./J_ r Date g h Telephone (772) 569-6680 Comments .•`(' ❑ Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's Ooodplain management ordinance can complete Sections A. B, C (or E), and! G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters. Gi. ❑ 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.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMAissued or community -Issued BFE) or Zone AD. G3. ❑ The following information (Items G4-G9) is provided for community floodplam management purposes. 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 GSO.Community's design flood elevation: , _ ❑ feet ❑ meters Datum Local Officials Name Title Community Name, Telepnone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-033 (7/12) Replaces all previous f ELEVA71ON CERTIFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. IMPORTANT; In these spaces, copy the comspoodlnE lmormatlon 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: 3ry316 Orange park Avenue, lot 49 staro Code companywuc Number. €l Pierce Fl34947 If usingthe Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below accordingto 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 View." 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 ion this page, use the Continuation Page. Aront (7/30/13) 041 J r�ffh a5 a �I y 'L pI 1 1 Side (7/30/131 t^s2if"� M:i Y FEMA Form 086433 (7112) Replaces all previous editions. US. DEPARTMENT OF HOMELAND SECURITY -f ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY I Expiration Date: July 31, 2015 National Flood Insumnaa Frogmen IMPORTANT: Follow the instructions on pages 1-9. Job#: 13-157B SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Ai. Building Owner's Name Seminole Mobile Park, LLC Policy Number: A2. Buildin Street Address in if Apt., Unft, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 318 Oran a Park Avenue, lot 49 city Ft. Pierce State FI ZIP Code 34947 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 2408-243-0003-000-6, Lot 49 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 27 4477 N Long. 80.3603 W Horizontal Datum: 0 NAD 1927 ❑ 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 5 A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq it a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawlspace or 0 b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑Yes NNo d) Engineered flood openings? ❑Yes NNo SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number B2. County Name 83. State St. Lucie CountyUnincorporated Areas 120285 St. Lucie Florida B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ BE. Flood Zone(s) B9. Base Flood Elevation(s) (Zone Revised Date AD, use base flood depth) 12111C0178 U 02/16/2012 02/16/2012 A N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9: ❑ FIS Prafile N FIRM ❑ Community Determined ❑ Other/Source: Bli. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source: B32.Is the building located in Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes NNo Designation Date: / / ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* N Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Ai-A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified In Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: "LURE" Vertical Datum: 20.385' NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® 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) 20 9 N feet ❑ meters b) Top of the next higher floor N A N feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N A N feet ❑ meters d) Attached garage (top of stab) N A ® feet ❑ meters e) 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) 18 , 3 N feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 18 , 5 ® feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N , A N 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. I certify that the Information on this Certificate represents my best efforts to interpret the data available. 1 understand 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. Check here if attachments. Were latitude and longitude In Section A provided by a licensed land surveyor? ® Yes ❑ No Beach 01- -4416- FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 , IMPORTANT: In these spaces, copy the corresponding information from Section JL FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: State ZIP Code I Comparry SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3). building owner. - Signature Date 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 E3-E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B.and For Items Ei-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 2 4 N feet []meters ® above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is 2' . _C� N feet ❑ meters ® above or ❑ below the LAG, E2. For Building 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 (elevation C2.b in the diagrams) of the building is —N A N feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is KJ A N feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _&-�. A N 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 I 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) of Zone AO must sign here. The statements.in Sections A, B, and E are correct to the best of my knowledge. I Property Owner or Owner's Authorized Representative's Name William E. Hayhurst Address 445 9th Street SW, Unit 7 City Vero Beach FI State ZIP Code �2962 Signature Date Telephone r R S L�h (772) 569-6680 Comments , ❑ Check here if attachments. 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), antl G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8-GSO. 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 dale of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E far a building located in Zone A (without a FEMA-issued or commun*issued BFE) or Zone AD. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued r-r I.,. G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: . _ El 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 ..11,6101 a wdnre ritle - wmmumry name, Telepnone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-033 (7/1.2) Replaces all previous editlons� ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6• IMPOR'7AND in these spaces, copy the cmmpondit Infomratlon 6om Section A. FORINSURANCE COMPANY USE Building Street Address (including Apt., Unit suite, and/or Bldg. No.) or P,O, Route and Box No. . Policy Nunn r. 3t3y 18 Oranq ?arts Avenue, lot 48 comps q NAIc tvmner. A R Pi ee F1� 34947 If usingthe 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; "Font View" and "Rear View"; and, if required, "Right Side View' and "Left Side Mew" 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 ion this page, use the Continuation Page. Front (7/30/13) Fro " Side (7/30/131 =a t W I T l +§,4f t I YY 3Y rS ' I R ti 1 a �� }��Y 7 �, x� ✓{ n FEMA Form 086033 (7/I2) Replaces all previous edkions.