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HomeMy WebLinkAboutELEVATION CERTIFICATEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program OMB No. 1660-0006 Expiration Date: November 30, 2018 ELEVATION CERTIFICATE SCANNED Important: Follow the instructions on pages 1-9. BY/ }},� Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company�� 9 (ggMGltl6 owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number. MR. & MRS. SAUL A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number. Box No. 1343 NETTLES BOULEVARD City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 1343 NETTLES ISLAND SECTION 2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, eta) RESIDENTIAL A5. Latitude/Longitude: Lat 27*17'03.62" N Long.80°13'16.37" W Horizontal Datum: ❑ NAD 1927 0 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 crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) o.00 sq ft b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0.00 sq in d) Engineered flood openings? ❑ Yes 0 No A9. For a building with an attached garage: a) Square footage of attached garage 384.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 2 c) Total net area of flood openings in A9.b 400.00 sq in d) Engineered flood openings? 0 Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State UNICORP / 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 12111C 0311 J 02-16-2012 02-16-2012 AE 6.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item Bg: ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 0 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 Form 086-0-33 (7/15) Replaces all previous editions. Farm Page 1 of 6 0) p ELEVATION CERTIFICATE OMB 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. 1343 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑x Construction Drawings* ❑ 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, V1-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 A7. In Puerto Rico only, enter meters. Benchmark Utilized: 94 77 A04 FLDT Vertical Datum: NAVD 1988 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) 7.0 ❑x feet ❑ meters b) Top of the next higher floor 16A ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters d) Attached garage (top of slab) 4.5 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 7,0 ❑ feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.1 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 4.3 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4.2 ❑x 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. I understand that any false statement maybe punishable by fine orimodsonment under 16 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Cer ifier's Name License Number '� 0✓5 # (3ZD-108- VL EARLE R. STARKEY 004459 Title PROFESSIONAL LAND SURVEYOR Place Company Name ACCURIGHT LAND SURVEYING, INC. �Q`d Address 1501 DECKERAVENUE, UNIT419D 6'ii 12 (q City �� — -- - State ZIP Code STUA --Florida 34994 PL5 fk 00LI4S9 nature ' _ _ Date Telephone Ext 04-12-2019 (772)286-7694 NIA Copy all pages of this-Eleva o n is for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) C2(e) A/C PLATFORM Ag(d) FLOODVENT MODEL NUMBER 1540-520 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB 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. 1343 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) ForZones 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, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Tap 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 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 flocdplain 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 owners 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 Form 086-033 (7/15) Replaces all previous editions. Forth Page 3 of 6 ELEVATION CERTIFICATE OMB 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. 1343 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH Florida 34957 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 GB-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. (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 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: Elfeet ❑ 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 (7/15) Replaces all previous editions. Forth Page 4 of 6 DIVISION: 08 00 00—OPENINGS SECTION: 08 95 43—VENTS/FOUNDATION FLOOD VENTS REPORT HOLDER: SMARTVENT PRODUCTS, INC. 430 ANDBRO DRIVE, UNIT 1 PITMAN, NEW JERSEY 08071 EVALUATION SUBJECT: SMART VENT® AUTOMATIC FOUNDATION FLOOD VENTS: MODELS #1540-520; #1540-521; #1540-510; #t1540-511; #1540-570; #1540-574; #1540-524; #1540-514 ICC ICC ICC Look for the trusted marks of Conformity! '2014 Recipient of Prestigious Western States Seismic Policy Council (WSSPQ Award in Excellence" A Subsidiary of ICC-ES Evaluation Reports are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use. There is no warranty by ICC Evaluation Service, LLC, express or implied, as EI to any finding or other matter in this report, or as to anyproduct covered by the report. Copyright © 2016 ICC Evaluation Service, LLC. All rights reserved. ESR-2074 I Most I49delyAccepted and Trusted Page 2 of 3 ■ Below the base flood elevation. ■ With the bottom of the FV located a maximum of 12 Inches (305A mm) above the higher of the final grade or floor and finished exterior grade Immediately under each opening. 6.0 CONDITIONS OF USE The Smart Vent® We described in this report comply with, or are suitable alternatives to what is specified In, those codes listed In Section 1.0 of this report, subject to the following condjtions: 5.1 The Smart Vent® FVs must be Installed In accordance with this report, the applicable code and the manufacturer's installation Instructions. In the event of a conflict, the Instructions in this report govern. 5.2 The Smart Vent® FVs must not be used in the place of "breakaway walls" in coastal high hazard areas, but are permitted for use In conjunction with breakaway walls In other areas. 6.0 EVIDENCE SUBMITTED Data in accordance with the [CC -ES Acceptance Criteria for Mechanically Operated Flood Vents (AC364), dated August 2015. 7.0 IDENTIFICATION The Smart VENT® models recognized in this report must be Identified by a label bearing the manufacturer's name (Smarivent Products, Inc.), the model number, and the evaluation report number (ESR-2074). TABLE 1—MODEL SIZES MODEL NAME FlgodVEN MODEL NUMBER 1540-520 MODEL SIZE (In.) 15 /4' X 7 /4" COVERAGE (sq. ft.) 200 SmarIVENT® 1540-510 15'/4" X 73/4" 200 FloodVENT® Overhead Door 1540-524 153/4" X 7'/4° 200 SmarlVENT® Overhead Door 1540-514 153/a" X 73/4" 200 Wood Wall FloodVEN 1540.570 14" X 8 /4" 200 Wood Wall FloodVEN Overhead Door 1540-574 14" X 83/4' 200 SmartVENr Stacker 1540-511 16" X 16" 400 FloodVent Stacker 1540-521 16"X 16" 400 �i Zc , u,u, - 25.4 mm; i squareroot= m