HomeMy WebLinkAbout200 NE 2 Ave U,S�-ILPART,AENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31, 2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number.
200 NE 2ND AVENUE
City DANIA BEACH State FL ZIP Code 33004
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 13,BLOCK 1,FLORIDA VILLAGE HIEGHTS,P.B.89, PG.22,B.C.R.
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude: Lat.26A03'21.4"W Long.80A08'29.3'W Horizontal Datum: ❑ NAD 1927 E NAD 1983
A6. Attach at least 2 photographs of the building if 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) NA sq ft a) Square footage of attached garage NA 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 NA within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes E 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
DANIA 120034 BROWARD FL06RIDA
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7. FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
120034 0309 F F 8/18/92 Effective/Revised Date Zone(s) AO,use base flood depth)
10/2/97 AE 7.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 139: E NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes E No
Designation Date: ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: ❑ 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/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:SEE COMMENTS Vertical Datum:
Indicate elevation datum used for the elevations in items a)through h)below. E NGVD 1929 ❑ 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) 8.45 E feet ❑meters
b)Top of the next higher floor NA. E feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) NA. ❑feet ❑meters
d)Attached garage(top of slab) 7.45 E feet ❑meters
e)Lowest elevation of machinery or equipment servicing the building ❑feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 6.3 E feet meters
g)Highest adjacent(finished)grade next to building(HAG) 7.4 E feet ❑meters
h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support ❑feet �u 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.1 certify that the information on this Certificate represents my best efforts to interpret the data available. S
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided tw a
❑ Check here if attachments. licensed land surveyor? E Yes ❑ No
Certifier's Name ERNEST W.DUNCAN License Number 5182 ,
Title LAND SURVEYOR Company Name ERNEST DUNCAN,P.S.M.5182
Address 521 SE 5T"COURT City POMPANO BEACH State FL ZIP Code 33060
Signature Date 8/17/13 Telephone 7542642166 I i
J
ELEVATION CERTIFICATE, page 2
Ir"PJRT.;NT: 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:
200 NE 2ND AVENUE
City DANIA BEACH State FL ZIP Code 33004 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 A5)GOOGLE EARTH
BENCHMARK-MANHOLE RIM AT INTERSECTION OF NE 2ND PLACE&NE 2ND AVE.ELEV.=4.60 NGVD
Signature Date 8/17/13
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 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 2 djacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is 0 ❑feet ❑meters ❑above or❑ below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is .0 ❑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 hi13her 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 0. ❑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 managerent
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-is:,ued E�FE)
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 community's floodplain management ordinance can complete Sections A,B,C(:)r 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.