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Home My WebLink AboutELEVATION CERTIFICATEU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program OMB No. 1660-0008 Expiration Date: November 30, 2018 ELEVATION CERTIFICATE SCANNED Important: Follow the instructions on pages 1-9. ��}} II'' IIrr��BgqY/'!(��}}�� Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/c8l ilny`i; (994 itli�fg owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number. ANDREAS A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 541 NETTLES BOULEVARD City State ZIP Code JENSEN BEACH Florida 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 541, NETTLES ISLAND PROJECT, SECTION 2 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°17'15.15" N Long. 80013'26.37" W Horizontal Datum: ❑ NAD 1927 [ENAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 5 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0.00 sq ft b) Number of permanent flood openings in the crawlspace 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 0.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0.00 sq in d) Engineered flood openings? ❑ Yes 7 No SECTION B—FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community -Name & Community Number B2. County Name B3. State 120285 / UNINCORR 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 B9: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicalele vation 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: ❑KgBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 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: 541 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: ❑ 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, AR/A, ARIAE, AR/A1—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 A04 FDOT 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) 7.7 0 feet ❑ meters b) Top of the next higher floor N/A ❑ 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 7,8 ❑ ❑ feet meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade nextto building (LAG) 4A ❑x feet ❑ meters g) Highest adjacent (finished) grade nextto building (HAG) 4.5 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4.5 ❑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. l 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 or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ZYes []No ❑ Check here if attachments. Certifier's Name License Number J O 13 W 3 O I Q— 01 EARLE R. STARKEY 004459 Title PROFESSIONAL LAND SURVEYOR Company Name ACCURIGHT LAND SURVEYING, INC. - Address. 1501 DECKER AVENUE, UNIT 419 Pv ZI /7-01.9 City State ZIP Code STUART Florida 34994 Pt_s tt 004w59 Signature Date Telephone Ext. 10-21-2019 (772)286-7694 NIA Copy all pages o this Elevation Certificate and all attachments for (1) community official, (2) insurance agentfoompany, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) 02(e) A/C PEDESTAL 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: 541 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) 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 E1—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 6-9 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 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 P OVOI ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form 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. 541 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 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. (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: ❑ feet ❑ meters Datum Gg. 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 BUILDING PHOTOGRAPHS OMB No.1660.0008 ELEVATION CERTIFICATE See Instrucliorw for Hem A6. Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copythecorresponding Information from Section A. FOR INSURANCE COMPANY USE Building StreetAddress Qnduding Apt, Unit,, Suite, andfor Bldg No.) or P.O. Route and Box No. Policy Number. 541 NETTLES BLVD, cityStateBEACH S�eFL❑RIDAZIP Cede 34957 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item AS. Identify all photographs with date taken; "Front YevP and °R2aiVie'N; 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 A& If submitting more photographm than will fit on this page, usethe Continuation Page. 'w14 Cqto FA a IT }F Y M i4 2 tl "^ryx' PhIX o= Photo One. Caption FRONT 10/21/2019 1, i. Y z 4 4 'r q ii f if L 1 ti t� Photo Two Caption REAR 10/21/2019 FEMA Form 08r-"3 (7/15) Replaces all previous edgons. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No.166MOS ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30,2018 IMPORTANT: in these apaaesjcopythe cormspending Wrormatfon froan Section A. FOR. INSURANCE COMPANY USE Building Street Address (Including Apt4 Unit, Suite, and/or Bldg. No) or P.O. Route and Box No. Policy Number 541 NETTLES BLVD, city JENSEN BEACH StateFLORIDA ZIP Code 34957 Company NAIC Number If submitting more photographs than will fit on the preceding page; aft the additional photographs below. Identify all photographs with: date taken; 'Front VieW and "Rear- Yew`, and, if required, °Right Side ViewP and "Lett Side View." When applicable, photographs must showthe foundation: with representativeexamples of the flood openings or vents,. as Indicated in Section As. & 4 � 777� W c kis4{?Sa h' �e ' t t s i S f �� !rs kill Y Photo Three Caption RIGHT SIDE 10/21/2019 P n'D.:' .,.ter" +wrt yJ r� s y fi i N A�qp 4 '+�sq F�YC�; dE yf'Fj¢ #i 1 h5 Ike Y-� a.`1t remit 4 a f P �eFm Photo Four Caption LEFT SIDE 10/21/2019 FF_MA Form W6-D-33 p/15) .Replaces all previous editions. Form Page 6 of 6