HomeMy WebLinkAbout235 SE 3 Ave 2 42 " (\ G
U.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program
ELEVATION CERTIFICATE OMB Control Number: 1660-0008
IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 8-15 Expiration: 11/30/2018
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 JSE
Al. Building Owner's Name
DEE, ROBERT SCOTT 16-0851230 YC Policy Number:
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and
Box No. Company NAIC
Number:
235 SE 3 AVENUE
City DANIA BEACH State FL Zip Code 33004
A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description,etc.)
DANIA GOLF VIEW 36-50 B LOT 11,12 BLK 1 -5142 03 47 0100
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. N26002'53" Long. W80008'22" Horizontal Datum: C NAD 1927 Q NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 8
A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage:
a)Square footage of crawlspace or enclosure(s) 2658+- sq ft a)Square footage of attached garage 400+- -;q ft
b)Number of permanent flood openings in the b)Number of permanent flood cpenings
crawlspace or enclosure(s)within 1.0 foot in the attached garage within 1.0 foot
above adjacent grade 9 above adjacent grade 8
c)Total net area of flood openings in A8.b 1436+- sq in c)Total net area of flood operimp in A9.b 392+- sq in
d) Engineered flood openings? (Yes 9 No d) Engineered flood openings? (Yes (✓No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NAP Community Name&Community Number B2. County Name B3. State
DANIA BEACH- 120034 BROWARD FL
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s)
Revised Date (Zone AO, use be se flood
12011C 0567 H 08/18/2014 AE depth
08/18/2014 5.00(NAND 1988)
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9:
( FIS Profile 9 FIRM (Community Determined (Other/Source: _
B11. Indicate elevation datum used for BFE in Item 69: (NGVD 1929 q NAVD 1988 C Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? (—Yes t',� No
Designation Date: N/A (CBRS (OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: C1 Construction Drawings* C Building Under Construction* Q(Finished Constructior
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,V1430,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: GPS Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ( NGVD 1929 (;/NAVD 1988
C 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) 4 00 P'feet (m aters
b) Top of the next higher floor -- 6 50 (7 feet (meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/ A (7 feet (meters
d) Attached garage(top of slab) 4 40 67 feet (meters
e) Lowest elevation of machinery or equipment servicing the building 4 35
(Describe type of equipment and location in Comments) C✓feet (meters
f) Lowest adjacent(finished)grade next to building(LAG) 3 67 (J feet (meters
g) Highest adjacent(finished)grade next to building(HAG) 3 87 C✓feet (meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/ A 67
structural support feet meters
(
FEMA Form 086-0-33(7/15) Replaces all previous editions. P 3ge 1 of 5
ELEVATION CERTIFICATE, page 2 OMB Control Number:1660-0008
Expiration: 11/30/2018
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.
235 SE 3 AVENUE Policy Number:
City DANIA BEACH State FL Zip Code 33004 Company NAIC
Number:
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. 1 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
❑ Check here if attachments. provided by a licensed land surveyor?
67 Yes ( No
Certifier's Name License Number
EFRAIN C. LOPEZ 2300&LB 7538 <y _
Title Company Name
P.L.S D'AVILA&ASSOCIATES SERVICES, INC ZJa vU
Address City State Zip Code
14750 NW 77TH COURT, SUIT 204 MIAMI LAKES FL 33016
Sgnaturey Date Telephone
G . 08/30/2016 (305)953-2600
Copy all pages of this Elevation.Certificate for(1)community official, (2)insurance agent/company, and(3)building owner.
Comments(including type of equipment and location, per C2(e), if applicable)
C.2.E REFERS TO AIR CONDITIONER MACHINERY SERVICING BUILDING LOCATED AT REAR OF THE SUBJECT PROPERTY
THESE ELEVATIONS WARNER MEASURED USING SURVEY-GRADE GLOBAL POSITION SYSTEM EQUIPMENT,THAT UTILIZES THE F.D.O.T.
PERMANENT REFERENCE NETWORK AS ITS HIGH ACCURACY REFERENCE NETWORK(H.A.R.N)
L.C.O.R=2.57';H.C.O.R=
Signature Date 08/30/2016
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 E1-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.
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, C feet C meters ❑ above or ❑ below the HAG.
or enclosure)is
b)Top of bottom floor(including basement,crawlspace, ('feet C' meters ❑ above or ❑ below the LAG.
or enclosure)is
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions), the next
higher floor(elevation C2.b in the diagrams)of the building is ('feet C'meters ❑ above or ❑ below the HAG.
E3. Attached garage(top of slab)is C feet ( meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is ( feet C 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 C No C-' 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 FLORIDA ZIP Code
Signature Date Telephone
08/30/2016
Comments
❑ Check here if attachments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 2 of 5
ELEVATION CERTIFICATE, page 3 OMB Control Number: 1660-0008
Expiration: 11/30/2018
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:
235 SE 3 AVENUE
City DANIA BEACH State FL Zip Code 33004 Company NAIC
Number:
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 iised 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.)
A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFI_)
G2. or Zone AO.
G3. The following information(Items 134-1310)is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Is;;ued
G7. This permit has been issued for: C New Construction C Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)
of the building: C�feet (�meters Datum
G9. BFE or(in Zone AO)depth of flooding at the
('feet ('meters Datum
building site:
G10. Community's design flood elevation: C feet C 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 at.achments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. F age 3 of 5
BUILDING PHOTOGRAPHS
ELEVATION CERTIFICATE, page 4 See instructions for Item A6. OMB Control Number: 1660-0008
Expiration: 11/30/2018
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.
235 SE 3 AVE Policy Number:
City DANIA BEACH State FL Zip Code 33004 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.
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FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 4 of 5
BUILDING PHOTOGRAPHS OMB Control Number: '660-0008
ELEVATION CERTIFICATE, page 5 Continuation Page Expiration: 11/30/2018
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:
235 SE 3 AVE
City DANIA BEACH State FL Zip Code 33004 Company NAIC
Number:
If submitting more photographs than will fit on the preceding page,affix the additional photographs below. Identify all photographs wth:date
taken;"Front View"and "Rear View"'and, if required, "Right Side View"and"Left Side View." When applicable, photographs must slow the
foundation with representative examples of the flood openings or vents,as indicated in Section A8.
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FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 5 of 5
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