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HomeMy WebLinkAboutEVALUATION CERTIFICATEU.S. DEPARTMENT OF HOMELAND SECUm ELEVATION CERTIFIC AT E FEDERAL EMERGENCY MANAGEMENT AGI2,.OMB No. 1660-0008 Natronal Flood lns once Program Important: Read the instructions on pages 1--0. Expiration Date: July 31, 2015 A2 Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O, Route and Box No. QLNumbet 10701 SOUTH OCEAN DRIVE #925 City JENSEN BEACH State FL ZIP Code 34957 SCANNED AS. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) BY LOT 925, VENTURE OUT IN AMERICA AT INDIAN RIVER SECTION E L' Lucie CUUI ItYRESIDENTIAL A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: LeL 27-16'13.5" N Long. 60`12'30.8" W Horizontal Datum: ❑ NAD 1927 2 NAD 1983 As. Attach at least 2 photographs of the building if the Certificate Is being used to obtain flood insurance. A7. Building Diagram Number 7 A8. For a building with a crawlspace or enclosum(s): A9. For a building with an attached garage: a) Square footage of crawispace or enclosum(s) M sq it a) Square footage of attached garage NIA sq it b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade 7 within 1.0 foot above adjacent grade NI✓A c) Total net area of flood openings in A8.b 15590 sq in c) Total net area of flood openings in A9.b N19 sq in d) Engineered flood openings? 0 Yes ❑ No d) Engineered flood openings? ❑ Yes ® No SECTION B-FLOOD INSURANCE RATE MAP (FIRM) INFORMATION ,cat, NIF Community Name & Community Number B2. County Name 83. State bNINGORP 120285 ST. LUCIE FL 84. Map/Panel Number B5. suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12111C 0314 J 02/16/2012 EffectivetRevised Date Zones) AO, use base flood depth) 02/1612012 AE 8.0 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 SHE in Item B9: ❑ NGVD 1929 X❑ NAVE) 1988 ❑ Other/Source: _ B12. Is the building located in a Coastal Barrier Resources System �BRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑X No Designation Date:-_ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction` © Finished Construction •A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones At-A30, AE, AH, A (with BFE), VE, VI-V30, V (with BFE), AR, ARIA, AR/AE, ARIA1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A02 RMt FLDT Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. 0 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) 4.1 0 feet ❑ meters b) Top of the next higher floor 8.0 Z feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA._ ❑ feet ❑ meters d) Attached garage (top of slab) N/A_ ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 9.8 N feel ❑ meters (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.0 El feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.1 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Ng._ ❑ 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 date available. 1890-01-01 I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. FFINAL FLOOD ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a © Check here if attachments. licensed land surveyor? © Yes El No PLACE Certfier's Name EARLE R. STARKEY License Number 004459 Adds 1501 DECKER AVENJX"#419/City SMART State FL ZIP Code 34994 / �J atme-FA'WR. STAKKF-V� Date 09/05/20_ 1, 4 = Telephone 772-286-7694 1 #4459 FEMA Form 03 -0-33 (7/12) See reverse side for continuation. Replaces all previous 15 `1 cq RIQ 1 -- v:51 _ ��L3 — l� • 58 �Nd i 6Y' ELEVATION CERTIFICATE, p;" 2 IMPORTANT: In these sil cog;,. corresoondina information from Section A - Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. City JENSEN BEACH State FL ZIP Code 34957 ( Company'NA1Cnt11mcer!Pr `s-" "i= ( SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. Signature EARLE R. STARKEY Date 0910512014 SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (wthout BFE), complate Items Ei-E5. lithe Certificate is intended to supporta LOMA or l-CIAR-F request, complete Sections A B, and C. For Items EI-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, entermeters. El. Provide elevation information forthe following and check the appropriate boxes to show whether the elevation is above ar below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enc(osure) is —_ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, 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/or 9 see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet Elmeters Elabove 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 onl : If no flood depth number Is available, is the top of the bottom floor elevated in accordance with me community's floodplain management ordinance? LJ 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 owners authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zane AO must sign here. The statements in Sections A, B. and E are correct to the best of my knowledge. Property Owners or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments G - COMMUNITY 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-G70. 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.) 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. G5. Date Permit Issued G7. This permit has been Issued for. LJ New Construction LJ 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 Officials Name Tille Community Name Telephone Signature Date Comments LJ ChegkKigirg 'rf attachments