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1112ACOUSC250165A 2012 CHET HE 40' 1313 7=254 11INW-1951
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STEEL BEC(MIERY SOLWIMS �C
2221 FLORA AVE
FORT � , li'L 33907-4224
Mail TO.
STEEL PEC(WERX SOLWJ�S
2221 i=� Aw
FORT bffERS, � 33907-4224
SCANNED
BY
St. Lucie County
0
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1. Men mumuship 0 the rabide deserted hemin is
transferred, Is sder MUST oemplete In full Me
Thansher d TWe by Seffer seems al Me bestorn 0
the continues & Us
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Me notive of see on Me te�erss side & this form.
3. Reen. You, bromse Plans hore the
4. See Me mb address home for mars, mimmuffion and
Me appropriate fismus; requinsel her the punsimener to
[me amc! M,W., Me �, rnooda home ., vesae:
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112ACOHSC250165A 2012 CH14T
HE 40, 131327254
91
Registered Ovrncln.
Date of Issue 07/13/2018 U.n Release
GEMIROLE DFhT R, LLC
Interest in the described vehice is hereby released
BY.
3318 ORANGE AvE
True
FORT PIERCE, FL 34947-3522
D.i.
IMPORTANT INFOR1I%TIOX
1. When ownership of the vehide described herein Is
transferred. the seller MUST compete In full the
Tmsfer of Tille by Seller section at the bottom of
Mail To:
the certificate of WE.
SHMINGLE DEALER, LLC
2. Upon sale of this vehicle, the sailer must complete
the notice of sale an the reverse side of this form,
33113 ORANGE AvE
3� Remove your license plate from the vehide.
FORT PIERCE, FL 34947-3522
4. Bee the web address below for mom informajoilt and
the appmimale forms required for the purchaser to
tile and register the vehicle. mobie home or veszek:
hflplA�.hsmv�l.a.H.urdhtmMInt.htmI
Flop Dula offs5y.
0Xq
RE M 14OLF DFA'L'E'R'*'LLC
3a16'0R4k0i,AVt'
RxElkm�' rL 34947-3522.
ist Limffiwaef�
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mobile home. Filing this form removes my civil liabil
keep a copy of you bill of We (we suggest it be notad:
below, tear the top portion of this document at the
I have this — day of
Name: Purchaser(s)
First
UNDER PENALTIES OF PERJURY, I DECLAREI
Seller's Signature
i
45,
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STATE OF FLORIDA
I'MENT OF HIGHWAY SAFETY AND MOTOR VEI - -S
DIVISION OF MOTOR VEHICLES
Parkway - Neil Kirkman Building - Tallahassee, Fl. 32399-0620
On of Sale of Motor Vehicle, Mobile Home or Vessel
r file a Notice of Sale with the department within 30 days after the sale or ftansfer of the motor vehicic� vessel or
for the operation of the sold motor vehicle� vessel or mobile home. In addition to filing this furrit, we suggest yen
, certificate of title or other type of transaction document showing the vehicle was sold. -Complete the information
foration and mail to the add� 2bove or submit toyour local tax collmtor's office or license plate agency.
nsferred by assignment of and delivered Florida Cerfificate of Title to:
Purchaser's DLAO
MI Last
Selling Price $
,T I HAVE READ THE FOREGOING DOCUMENTAND THATTHE FACTS STATED IN ITARE TRUE.
. Co -Sellers Signatur
1ATELY COMPLETED, TO A TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCY OR TO THE
IKTjD.UPDATETHF E)MV.DATABASF-To REf:LEGT-THE-TITLE-RECORDASI'SOLD". HOWEVER,
JNTIL THE PURCHASER APPLIES FOR AND IS ISSUED A CERTIFICATE OF TITLE.
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U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program I
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent1company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
�1. Building Owners Name
Policy Number:
ENE ESTRADA
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number.,
Box No.
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
FORTPIERCE Florida 34947
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
SEMINOLO MOBIL PARK, PARCEL ID: 2408-243-0003-000-6
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) MANUFACTURED HOME
)(A5. Latitude/Longitude: Lat. 27*26'53.4" N Long.,80*2 14.3 2" Horizontal Datum: E] NAD 1927 N NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
it AT Building Diagram Number 5 SCANNED
A8. For a building with a crawlspace or enclosure(s): BY
a) Square footage of crawlspace or enclosure(s) NIA sq ft St. Lude County
b) Number of permanent flood openings in the crawls7ace or 'enclosure(s) within 1.0 foot above adjacent grade..WLJL,
c) Total net area of flood openings in A8.b 0.� N/A sq in
d) Engineered flood openings? El Yes 0.5LN&
A9. For a building with an attached garage:
a) Square footage of attached garage N/A sq ft go'
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A bo'
c) Total net area of flood openings in A9.b N/A sq in OP
d) Engineered flood openings? E] Yes Z Noe
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORPORATED 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 AD, use Base Flood Depth)
Revised Date
12111C-0178
J
02-16-2012
02-16-2012
A
NIA
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
[—] AS Profile [] FIRM D Community Determined Fj Other/Source:
B1 1. Indicate elevation datum used for BFE in Item B9: E] NGVD 1929 El NAVD 1988 E] Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes F� No
Designation Date: E] CBRS F1 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:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
elevations are based on: E] Construction Drawings* [] Building Under Construction* 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, V1-V30, V (with BFE), AR, ARlA, ARIAE, AR/Al-A30, ARIAH, ARIAO.
Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Benchmark Utilized: Vertical Datum:
Indicate elevation datum used for the elevations in items a) through h) below.
[-] NGVD 1929 r-1 NAVD 1988 F� 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) feet E] meters
b) Top of the next higher floor feet E] meters
c) Bottom of the lowest horizontal structural member (V Zones only) E] feet E] meters
d) Attached garage (top of slab) E] feet meters
e) Lowest elevation of machinery or equipment servicing the building
E] feet meters
(Describe type of equipment and location in Comments)
9 Lowest adjacent (finished) grade next to building (�AG) E] feet E] meters
g) Highest adjacent (finished) grade next to building (HAG) E] feet. [-] meters
h) Lowest 2djacent gi�qde at lowest elevation 9f deck or stairs, including
E] feet E] 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. / understand that any false
statement may be 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? ElYes ONo E] Check here if attachments.
Certifier's Name License Number
CRAIG D. WATSON 5647
Title
PRESIDENT
Place
Seal
Company Name
SURVEYING AND MAPPING, INC.
WATSON KILLANE
Here
Address
2240 NE DIXIE HIGHWAY
city State ZIP Code
JENSEN BEACH Florida 34957
Signature Date Telephone Ext.
08-06-2019 (772) 334-0868
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/comparry, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
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:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
k
FOR ZONE AO AND ZONE A (WITHOUT l3FE)
For Zones AO and A (without BFE), complete Items EI-E5. If the Certificate is intended to support a LOMA or LOMR-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,
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 5.7 [E feet E] meters 2] above or E] below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is 5.2 [E feet E] meters N above or [-] below the LAG.
IE2. 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 E] feet E] meters E] above or E] below the HAG.
E3. Attached garage (top of slab) is E] feet E] meters [-] above or E] below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is E] feet E] meters E] above or D below the HAG.
E5. Zone AD 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? D Yes E] No F� Unknown. The local official must certify this information in Section G.
SECYON F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or c er's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or
` 0
community-i �F/orZone AD must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner o ners Authoriz:��tative's Name
CRAIG D. WA N
Address city State ZIP Code
2240 NE //HIGHWAY JENSEN BEACH Florida 34957
,Z
Signatu Date Telephone
08-06-2019 (772) 334-0868
Cc ants
Al 0 IGHT SIDE OF BUILDING ATTACHED, AND IS 8.0 FEET ABOVE LAG (SEE SHEET 6 - TOP)
F 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:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance ran 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-G1 0. 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. F] The following information (items G4-G1 0) 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 E] Substantial Improvement
G8. Elevation of as -built lowest floor (including basement)
of the building: [-] feet E] meters Datum
G9. BFE or (in Zone AO) depth of flooding at the bui!ding site: E] feet E] 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 locabon, 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 OM13 No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item AS. Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding Information from Section A.
Buildirig-Striet Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Policy Number:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
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PhotoTwoCaption REAR VIEW (08-06-2019)
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2018
A
M15511090w, Poll 11, �Wllj
Policy Number:
tpo]Zgml§Loi
Company NAIC Number
21-101-I&I-IMI W-11I 0
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FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6
A
X
U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program I
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Policy Number.,
RENE ESTRADA
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
3318 ORANGE AVENUE i2L3.8
J_
city State ZIP Code
FORT PIERCE Florida 34947
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
SEMINOLO MOBIL PARK, PARCEL ID: 2408-243-0003-000-6
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) MANUFACTURED HOME
)k5. Latitude/Longitude: Lat, 27*26'53.4" N Long. 80*21'43.2" Horizontal Datum: E] NAD 1927 NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being usedlo obtain flood insurance.
XT Building Diagram Number 5
For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq It
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b NIA sq in
d) Engineered flood openings? E]Yes E9 No
A9. For a building with an attached garage:
a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? E] Yes [xJ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bl. NFIP Community Name & Community Number
B2. County Name
B3. State
UNINCORPORATED 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 AD, use Base Flood Depth)
Revised Date
12111C-0178
J
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 0 Community Determined 7 Other/Source:
Bl 1. Indicate elevation datum used for BFE in Item B9: [—] NGVD 1929 [—] NAVD 1988 [] Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? El Yes El No
Designation Date: I—] CBRS F� OPA
FEMA Form 086-0-33 (7/16) Replaces all previous editions. Form Page I 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:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: E] Construction Drawings* E] Building Under Construction* E] 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, VI—V30, V (with BFE), AR, AR/A, AR/AE, AR/Al—A30, ARIAH, 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: Vertical Datum:
Indicate elevation datum used for the elevations in items a) through h) below.
E] NGVD 1929 [] NAVD 1988 F1 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, crawlspare, or enclosure floor) E] feet E] meters
b) Top of the next higher floor E] feet meters
c) Bottom of the lowest horizontal structural member (V Zones only) feet meters
d) Attached garage (top of slab) feet meters
a) Lowest elevation of machinery or equipment servicing the building
feet meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent (finished) grade next to building (LAG) feet meters
g) Highest adjacent (finished) grade next to building (HAG) feet meters
h) Lowest adjacent grade at lowest elevation nf cleck or stairs, including
structural support 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. / understand that any false
statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
Were latitude and longitude in Section A provided bya licensed land surveyor? E]Yes ONo E] Check here if attachments.
Certifier's Name License Number
CRAIG D,WATSON 5647
Title
PRESIDENT
Place
Company Name
WATSON KILLANE SURVEYING AND MAPPING, INC.
Sea[
Here
Address
2240 NE DIXIE HIGHWAY
city State ZIP Code
JENSEN BEACH Florida 34957
Signature Date Telephone Ext.
08-06-2019 (772) 334-0868
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
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:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A (WITHOUT IBFE)
For Zones AD 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 EI—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 5-7 Z feet E] meters 0 above or [] below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is 5-2 2] feet [1] meters Z above or E] 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 F] feet E] meters 0 above or [] below the HAG.
E3. Attached garage (top of slab) is feet E] meters E] above or E] below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is E]feet Dmeters 0 above or 0 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
floociplain management ordinance? E] Yes E] No F� Unknown. The local official must certify this information in Section G.
SECTIONY — PROPERTY OWNER (OR OW��REPRESENTATIVE) CERTIFICATION
The property owner or owner uthorized representative VJw-15,5mpletes Sections A, B, and E for Zone A (without a FEMA-issued or
community -is .;?ne AO must sign he�tatements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner or Own s Authorized Repr ritative's Name
CRAIG D. WATSON
Address city State ZIP Code
2240 NE DIXIE HWAY JENSEN BEACH Florida 34957
Signature Date Telephone
08-06-2019 (772) 334-0868
Comments
A/C ON RIGHT SIDE OF BUILDING ATTACHED, AND IS 8.0 FEET ABOVE LAG (SEE SHEET 6 - TOP)
Check here if attachments.
FEMA Form 086-0-33 (7115) 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:
3318 ORANGE AVENUE (LOT 38)
city State ZIP Code
Company NAIC Number
FORT PIERCE Florida 34947
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-G1 0. In Puerto Rico only, enter meters.
G1. F 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. F] 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. F-1 The following information (items G4-G10) is provided for community floodplain management purposes.
G4. Permit Number
rmit Issued
G6. Date Certificate of
Compliance/Occupancy Issued
G7. This permit has been issued for: E] New Construction E] Substantial Improvement
G8. Elevation of as -built lowest floor (including basement)
of the building: [-] feet E] meters Datum
Gg. BFE or (in Zone AO) depth of flooding at the building sitc: E] feet [-] meters Datum
G10. Community's design flood elevation: 0 feet E] 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. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018
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Policy Number:
Company NAIC Number
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all.
Z-A
AZ4
PhotoTwoCaption REAR VIEW (08-06-2019)
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2018
WOROMMIFTME: MM
Policy Number:
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Company NAIC Number
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Photo Four Caption LEFT SIDE VIEW (08-06-2019)
clear Photo Four
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6