HomeMy WebLinkAboutEC 116 NW 6 Ave FtUEl<AL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
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Important: Read the instructions on pages 1-7.
SECTION A-PROPERTY OWNER INFORMATION Fa Insurance Company lk e:
BUILDING OWNER'S NAME Policy Number
CARY GRANT
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
116 N.W.6THAVENUE
CITY STATE ZIP CODE
CITY OF DANIA BEACH FL 33004
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 18,BLOCK 7,T(YNN OF MODELO(NOW DANIA),PB.B,PG.49
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS(Type): —
( #ry°-#0'-##.ttr or ##.# #°) ❑NAD 1927 ❑NAD 1983 0 USGS Quad Map 0 Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1 NFIP COMMUNITY NAIA&COMMUNITY NUMBER B2 COUNTY NAME B3.STATE
CITY OF DANIA BEACH-126034 BROWARD COUNTY FL
B4.MAP AND PANEL B7 FIRM PANEL • 89.BASE FLOOD ELEVATION(S)
NUMBER B5 SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone AO,use depth oflkx ing)
12011C0307 F 10-2-97 8-18-92 X N/A
B10.Indicate the source of the Base Flood Elevation(BFE)data or base food depth entered in B9.
❑FIS Profile ®FIRM ❑Community Determined 0 Other
B11.Indicate the elevation datum used for the BFE in B9:0 NGVD 1929 ElNAVD9 ❑Other(Describe):
B12.Is the buidng located in a Coastal Barrier Resources Syslan(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ®No Desigiation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl.Bulking elevations are based on:❑Construction Drawings* ❑Buiking Under Ccnsfur hon* ®Finished Construction
*A new Elevation Certificate wit be requred wtien construction of the buidng is complete.
C2.Bulking Diagarn Number I(Select the buicing diagam most similar to the building far which this certificate is being completed-see pages 6 and 7. If no c iagarn
accurately represents the buidnhg,provide a sketch or photogaph.)
C3.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 C3.-a-i below according to the buiding ciagam specified in Item C2.State the datum used.If the datum's cifferent from the datum used for the BFE it
Section B,convert the datum to that used f x the BFE.Show field measurements and dahm conversion calculation. Use the space provided or the Comments area al
Section D or Section G,as dwiupidte,to document the datum conversion.
Datun NGVD Conversion/Corrrnents
Elevation reference marls used COUNTY Does the elevation reference male used appear on the FIRM'? ❑Yes ®No --
❑ a)Tap of boftnm floor(inducing basement or enclosure) 10. 7 ft.(m) - 1
❑ b)Top of next higher floor N/A. ft(m) rn i
❑ c)Bottcrn of lowest horizontal structural member(V zones only) N/A ._ft(m) 2'
0 d)Attached garage(thp of slab) 10.. 1 ft(m) .2 S
0 e)Lowest elevation of machihery and/or equipment W
servicing the buidng(Climate in a Ccrrrnents area) 10.5 ft.(m) S's- ` S IX "'�
❑ f)Lowest adjacent(finished)grade(LAG) _ C
g)Highest adjacent(finished)Bade(HAG) 10 60 ft(m) H c ti
0 h)No.of permanent openings(flood vents)within 1 ft.above aclacent Bade NA § - b`
0 )Total area of al permanent openings(food vents)in C3.h WA sq.in.(sq.cm)
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 in Sections A,B,and C 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.
CERTIFIER'S NAME STEPHEN H.GIBBS LICENSE NUMBER 4054
TfTLEPRESIDENT COMPANY NAME GIBBS LAND SURVEYORS
ADDRESS CITY STATE ZIP CODE
2131 HOLLYWOOD BOULEVARD,SUITE 201 HOLLYWOOD FL 33020
SIGNATURE � i� _ DATE TELEPHONE
422-2003