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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0)08
Federal Emergency Management Agency [Exr)ires
February 28,
National Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTION A- PROPERTY INFORMATION For Insurance Compary Use:
Al. Building Owner's.Name DOUBLE'D'LLC Policy Number
A2. Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number
509 NW 3 PLACE
City DANIA BEACH State FL ZIP Code 33004
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
5042 34 06 0470
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. NA Long. NA Horizontal Datum: ❑ NAD 1927 ® 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 1
A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide:
a) Square footage of crawl space or enclosure(s) 0 sq ft a) Square footage of attached garage 240+- sq ft
b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garace
enclosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2.County Name B3.State
TOWN OF DANIA BEACH 120034 IBROWARD FL
B4.Map/Panel Number B5.Suffix B6. FIRM Index B7. FIRM Panel B8.Flood B9.Base Flood EIeva•ion(s)(Zone
Date Effective/Revised Date Zone(s) AO, use base flood depth)
12011 CO309 F 10/2/97 8/18/92 X NA
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item 69: ® NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ®No
Designation Date ❑CBRS ❑OPA
SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction' ® 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-g
below according to the building diagram specified in Item AT
Benchmark Utilized 1131 Vertical Datum NGVD
Conversion/Comments
Check the measurement used.
a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 13.11 ®feet ❑meters(Puerto Rico only)
b) Top of the next higher floor N.A ❑feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) N.A ❑feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) 12.48 ®feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 12.36 Z feet ❑meters(Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent(finished)grade(LAG) 11.36 ❑feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade(HAG) 12:36 ®feet ❑meters(Puerto Rico only)
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.
/understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
❑ Check here if comments are provided on back of form.
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Certifier's Name WILLIAM B. GROOVER License Number 5190 �j •.
Title VICE PRESIDENT Company Name ALL COUNTY SURVEYORS, INC.
Address 5950 W OAKLAND PARK BLVD#108 City LAUDERHILL State FL ZIP Code 33313 ' \!
Signat re Date 1/7/07 Telephone 954-777-4747
FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions