HomeMy WebLinkAbout516 NW 3 St FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200
ELEVATION CERTIFICATE
Important Read the instructions on pages 1-7.
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME KELVIN& KIMBERLY DAISE Policy Number
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
516 N.W. 3RD STREET
CITY STATE ZIP CODE
CITY OF DANIA BEACH FL 330D4
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 3&4,BLOCK A,HANSON&NELSON SUBDIVISION
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) --
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'- ##" or fi#- ) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61 NAP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3 STATE —1
CITY OF DANIA BEACK120034 BROWARD FL J
B4 MAP AND PANEL B7 FIRM PANEL B9 BASE FLOOD ELEVATIONS)
NUMBER B5 SUFFIX B6 FIRM INDEX DATE EFFECTIVE/REVISED DATE 88 FLOOD ZONE(S) (Zone AO,use depth of flooding)
12011CM F 10-2-97 8-18-92 X N/A
810.Indicate the souse of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile ®FIRM ❑Community Determined ❑Other(Describe):
B11.Indicate the elevation datum used for the BFE in 139:®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 _
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Construction Drawings' ❑Building Under Construction' ®Finished Conshxbon
'A new Elevation Certificate will be required"con$lructon of the building is complete.
C2.Building Diagram Number 1(Select the buidng drag am most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch or photograph.)
C3.Elevations—Zones At-A30,AE,AH,A(with BFE),VE,VI-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,ARIAO
Complete Items C3.-a4 below according to the building diagram specified in Item C2.State the datum used.If the datum is different from the datum used for the BFE in
Section B,convert the datum to that used fox the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G,as appropriate,to document the datum conversion.
Datum NGVD Conversion/Carrrients
Elevation reference mark used COUNTY Does the elevation reference marls used appear on the FIRM? ❑Yes ®No
❑ a)Top of bottom floor(including basement or enclosure) 13. 2 ft.(m) o
❑ b)Top of next higher floor N/A._ft.(m) W
❑ c)Bottom of lowest hortzontal struchral member(V zones dirty) N/A._ft.(m) o
❑ d)Attached garage(top of slab) WA. _flL(m) E
❑ e)Lowest elevation of machinery ardor equpment w M �� J servicing the building(Describe in a Comments area) 12.6 ft.(m)
❑ t)Lowest adjacent(finished)grade(LAG) 12.0 ft.(m) z' T
❑ g)Highest adjacent(finished)grade(HAG) 12. 3 ft.(m) N N
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade N/A M
J
❑ )Total area of all permanent openings(flood 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,
l understand that any false stafement maybe punishable by fine or imprisonment under 18 U.S. Code Section 1001.
CERTIFIERS NAME STEPHEN H.GIBBS LICENSE NUMBER 4054
TITLEPRESIDENT COMPANY NAME GIBBS LAND SURVEYORS
ADDRESS _ CITY STATE ZIP CODE
2131 HOLLYWOOD BOULEVARD,SUITE 2G1 HOLLYWOOD FL 33020
SIGNATURE DATE TELEPHONE
03-20-2003 954-923-7666