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HomeMy WebLinkAboutELEVATION CERTIFICATE WITH PHOTOSU.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY M,vioml P1?od Insurance Program ELEVATION CERTIFICATE .cant: Read the instructions on page OMB No. 1660-0008 Expiration Date: July 31, 2015 At PATRICK & SECTION A - PROPERTY INFORMATION I FOR INSURANCE COMPANY USE A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 18" WILDCAT COVE DR City FORT PIERCE AT THE SANDS. ST. LUCIE State FL ZIP Code Number: A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longflude: Lat. 27.228340 Long. 80.301922 Horizontal Datum: ❑ NAD 1927 X NAD 1983 As. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1 B A& 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) WA sq ft a) Square footage of attached garage 625 sq ft 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 N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in Ag.b N/A sq in d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. Carnty Name B3. Stare St LUCIE COUNTY-120285 ST LUCIE COUNTY FLORIDA B4. MaplPanel Number 65. Suffa Bit. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Effective/Revised Date Zones) AO, use base flood depth) 0181 J 211612012 2MG12012 AEE 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' X 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: COUNTY Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 X 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) 6.1 X feet ❑ meters b) Top of the next higher floor NIA ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A_ ❑ feet ❑ meters d) Attached garage (top of slab) 5_6 X feet ❑ meters a) Lowest elevation of machinery or equipment servicing the building 5_4 X feet ❑ meters (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) 4_9 X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) - 1_11 Xfeet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 4_9 X 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. x Check here if comments are provided on back of forth. Were latitude and longitude in Section A provided by a x Check here 9 attachments. licensed lard surveyor? X Yes ❑ No Certifiers Name REGINA KARNER License Number 4363 Title President Company Name KARNER SURVEYING INC Address 2740 S'fat MARTIN S BLVDA333 City PALM CITY State FL ZIP Code 349M Signature f_ff A k Date 2I19/2014 Telephone (772) 288 T206 JOB#1301.2907 Revised 4.14.2014 Revised 4.16.2014 Revised 4.17.2014 FEMA Form @96p-33 (7112) reverse side for continuation. Replaces all previous editions. IMPORTANT: In these spaces, copy the corresponding information from Section A. - FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, 'or Bldg. No.) or P.O. Route and Box No. Policy Number. 11848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 Company NAIL Number 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 One Story Residence with a screened pool and Patio at elevation 5.5. Utility pads are as follows: A/C pad at elevation 5.4, Pool EaulaMent at Elevation 5.4 Date 2119/2014 (Revised 4.14.2014, 4.16.2014, 4.17.2014) SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete hems Ei-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) 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 8-9 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, 8, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowledge. Property Owners or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone 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), 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 I G5. Date Permit Issued I 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 she: _ _ ❑ feet ❑ meters Datum G10. Community's design flood elevation: _ _ ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 3uilding Photographs See Instructions for item A6. IMPORTANT: In these spaces, copy the 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. I Policy Number. 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 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 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 on this page, use the Continuation Page. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 '30ding Photographs Continuation Page IMPORTANT: In these spaces, copy the conesponding 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. 7ti48 WILDCAT COVE DR City FORT PIERCE Stale FL LP Code 34949 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions. U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENC OMB No. 1660-0008 Naliorml Flood lnaaramceProgram portant: Read the instructions on pag -9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name PATRICK & MARY MARCELLO Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 1848 WILDCAT COVE DR City State FL ZIP Code 34949 LOT 43, RIVERPOINTE AT THE SANDS, ST. LUCIE COUNTY t3Y A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL • Lucie Coon A5. Latitude/Longitude: Lat. 27.228340 Long. 80.301922 Horizontal Datum: ❑ NAD 1927 X NAD 1983 A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance. AT Building Diagram Number I A8. 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 625 sq ft 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 N/A within 1.0 foot above adjacent grade NIA 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 ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bt. NFIP Community Name & Community Number B2. County Name B3. State St LUCIE COUNTY-120285 ST LUCIE COUNTY FLORIDA B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Eftea2//Revs Date Zone,.(s) AO, use bass flood depth) 0181 J 9/19/1999 2 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 139: ❑ 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' X 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, V1-V30, V (with BFE), AR, ARM, AR/AE, AR/A1-A30, AR/AH, AR/AD. Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: COUNTY Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 X 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) 6.1 X 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) 5_6 X feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 5_4 X feet ❑ meters (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) 4_9 X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5_1 Xfeet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 4_9 X 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. x Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a x Check here it attachments. licensed land surveyor? x Yes ❑ No Certifiers Name REGINA KARNER License Number 4363 Address 21 SW MARTIN DAWNS BLVD.0333 City PALM CITY State FL ZIP Code 34990 Signature f1VA 4<-)J 8 Date 2/1912014 Telephone (772) 288 7206 JOB#1301.2907 Revised 4. 14.2014 FEMA Forkh 0#6.0-33 (7/12) See reverse side for continuation. Replaces all previous editions. IMPORTANT: In these spaces, copy the corresr^^wing information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, andh g. No.) or P.O. Route and Box No. Policy Number: 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent1company, and (3) building owner. Comments One Story Residence�with a screened pool and patio at elevation 5.5. Utility pads are as follows: A/C pad at elevation 5.4, Pool Equipment at Elevation 0A Signature / Date 2/19/2014 (Revised 4.14.2014) SECTIO 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 El-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 ❑ 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 8-9 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's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys 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 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 ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, pages Building Photograph! - See Instructions for Item A6. 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: 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 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 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 on this page, use the Continuation Page. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page. Building Photograph: Continuation Page 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 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 Company NAIC Number. If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions. U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY Nariorwl Flood Ircraraaoe Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Al. Building Owner's Name A2. Building Street Address (including Apt., Unit Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number. 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 LOT 43, RIVERPOINTE AT THE SANDS, ST. LUCIE COUNTY A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL St. Luce Cou* A5. Latitude/Longitude: Lat. 27.228340 Long. 80.301922 Horizontal Datum: ❑ MAD 1927 X NAD 1983 AS. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number I As. 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 625 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 N/A within 1.0 foot above adjacent grade N/A 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 ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 6F Stale St LUCIE COUNTY-120285 ST LUCIE COUNTY FLORIDA B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B6. Flood B9. Base Flood Elevation(s) (Zone I Effective/Revised Date I Zones) AO, use base flood depth) 0181 J 9119119" 2/16/2012 AE 5 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in hem B9. ❑ FIS Profile X FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 69: ❑ 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 ❑ ORA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' X 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, ARM, AR/AE, AR/Al—A30, AR/AH, ARIAO. Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: COUNTY Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 X 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) 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) 1) 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 6.1 X feet ❑ meters N/A ❑ feet ❑ meters N/A. ❑ feet ❑ meters 5_6 X feet ❑ meters 5_4 X feet ❑ meters 4_9 X feet ❑ meters 5_1 Xfeet ❑ meters 4_9 X 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. x Check here it comments are provided on back of form. Were latitude and longitude in Section A provided by a JOB#1301.2907 x Check here d attachments. licensed land surveyor? x Yes ❑ No Revised 4.14.2014 Certfier's Name REGINA KARNER License Number 4363 Title President Company Name KARNER SURVEYING INC Address 2Q SW N DOWNS BLVD.#333 City PALM CITY State FL ZIP Code 349N Signature Date 2/19/2014 Telephone (772) 286 7206 FEMA Fo frn 486-0-33 (7112) See reverse side for continuation. Replaces all previous editions. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Sure, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 Company NAIC Number: 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 One Story Regssidence with a screened pool and patio at elevation 5.5. Utility pads are as follows: A/C pad at elevation 5.4, Pool Equipment at EI¢vation 5.4 S"ure Date 2/19/2014 (Revised 4.14.2014) 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 Et-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. 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 (RAG) 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 endosure) 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 ❑ 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's or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here ff 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), and G of this Elevation Certificate. Complete the applicable rem(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 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 ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. I FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Policy Number. WIL DCAT LDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 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 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 on this page, use the Continuation Page. REAR Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page 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. 1848 WILDCAT COVE DR City FORT PIERCE State FL LP Code 34949 Company NAIC Number. If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions. U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE PATRICK & MARY MARCELLO A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number. 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 LOT AT THE SANDS, ST. LUCIE Legal Description, etc.) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27.228340 Long. 80.301922 Horizontal Datum: ❑ NAD 1927 X NAD 1983 A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1 B AS. 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 625 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 WA within 1.0 foot above adjacent grade N/A 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 ❑ No 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 1 ST LUCIE COUNTY I FLORIDA B4. Map/Panel Number B5. Suffix BE. FIRM Index Date B7. FIRM Panel B8. Flood B9 Base Flood Elevation(s) (Zone Effective/Revised Date Zones) AO, use base flood depth) 0181 J 9/19/1999 2/16/2012 AEE 5 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' X 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, AR/A, AR/AE, AR/AI-A30, AR/AH, AR/AD. Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: COUNTY Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 X 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) 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 6.1 X feet ❑ meters N/A ❑ feet ❑ meters N/A. ❑ feet ❑ meters 5_6 X feet ❑ meters 5.4 X feet ❑ meters 4.9 X feet ❑ meters 5.1 Xfeet ❑ meters 4.9 X 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. x Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a x Check here if attachments. licensed land surveyor? It Yes ❑ No Certifier's Name REGINA KARNER License Number 4363 Title President Company Name KARNER SURVEYING INC Address 2740 MAR N DOWNS BLVDA333 City PALM CITY State FL ZIP Code 34990 Signature q%" Date 2/19/2014 Telephone (772) 288 7206 JOB#1301.2907 Revised 4.14.2014 #Mt_C,_ FEMA Form See reverse side for continuation. Replaces all previous editions. 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. ' 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 ' Company NAIC Number. 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 One Story Residence with a screened pool and patio at elevation 5.6. Utility pads are as follows: A/C pad at elevation 5.4, Pool Equipment at Elevation 5.4 Signature Date 211912014 (Revised 4.14.2014) 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 Et-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items Et-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 ❑ 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 8-9 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's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments Check here ff attachments. The local official who is authorized by law or ordinance to administer the communitys 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 G8-4G10. 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: G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: Local Official's Name Title ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum Community Name Telephone Signature Date Comments Check here it attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. 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: 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 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 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page 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. 1848 WILDCAT COVE DR City FORT PIERCE State FL LP Code 34949 Company NAIC Number. If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View; and, if required, "Right Side Yew" 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. Ri ht Front Left Rear J 7- FEMA Form 086-0-33 (7/12) Replaces all previous editions. U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program 1 ELEVATION CERTIFICATE rtant: Read the instructions on pages OMB No. 1660-0008 Expiration Date: July 31, 2015 SECTION A — PROPERTY INFORMATION ) FOR INSURANCE COMPANY USE ) Al. Bulling Owners Name PATRICK & MARY MARCELLO 3 Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number. 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 no. riuyeray Uescopuun tw, anu DIUu numuers, i as rarcei rrumum, Legal �saryuun, ea:.t LOT 43, RIVERPOINTE AT THE SANDS, ST. LUCIE COUNTY B 1 pv A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL StladeCuunw A5. Latitude/Longitude: Lat. 27.228340 Long. 80.301922 Horizontal Datum: ❑ NAD 1927 X NAD 1983 A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance:= AT Building Diagram Number 1B AS. 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 625 sq ft 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 N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b WA sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ❑ No 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 4UCIE COUNTY-120285 ST LUCIE COUNTY FLORIDA B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Effective/Revised Date Zone s) AO, use base flood depth) 0181 J 6/30/1999 8/19/91-2/16/2012 Ads 5 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: _ B 11- Indicate elevation datum used for BFE in Item Bg: ❑ NGVD 1929 X NAVD 1988 ❑ Other/Source: _ 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes X No Designation Date: _ ❑ CBRS ❑ OPA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. 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 At—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 AT In Puerto Rico only, enter meters. Benchmark Utilized: COUNTY Vertical Datum: NAVD Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 X 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) 6.2 X feet ❑ meters b) Top of the next higher floor NIA ❑ 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 N/A ❑ feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.5 X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 5.0 Xfeet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A ❑ 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 avadabie. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. x Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a x Check here it attachments. licensed land surveyor? x Yes ❑ No Certifiers Name REGINA KARNER License Number 4363 Title President Company Name KARNER SURVEYING INC Address 27t SW TIN DOWNS BLVD.#333 City PALM CITY State FL ZIP Code 34990 Signature a(\ 0 Date 6/14/2013 Telephone (772) 288 T206 JOB#1301.2905 #d -EMA Form"08$-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANYLSE I Building Street Address (including Apt., Unit, Suite, am Idg. No.) or P.O. Route and Box No. Policy Number. -yl 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 ( Company NAIC Number. 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 One Story Residence with a screened pool and patio at elevation 12.4. Utility pads are as follows: A/C pad at elevation 12.9, Pool Equipment at Elevation 12.6 and Pool Heater at Elevation 12.9 NoteAte pips se Flood Elevation determined is within a few hundred feet of the property and has a Base Flood Elevation of 6 e rl Date 5122/20113 SEZ,tTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete hems 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. Ell. 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 8-9 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 Ior l 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's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments SECTION G-COMMUNITY INFORMATION (OPTIONAL) ❑ Check here it attachments. The local offetal 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 items) and sign below. Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters. Gt. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architectwho 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/Oocupancy 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 Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, Copy the corresponding information from section A. FOR INSURANCE COMPANY USE Building Street Andress (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 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 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 on this page, use the Continuation Page. IRV r- FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Stregt Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number. 1848 WILDCAT COVE DR City FORT PIERCE State FL ZIP Code 34949 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. FEMA Form 086-0-33 (7/12) Replaces all previous editions.