HomeMy WebLinkAbout565 Forest View Cir ---^�^ OMB No. 1660-0008 j
DEPAR7,1Zt4T OF HOMELAND SECURITY _LEVATION CERTIFICATE Iv l,�'� Expires February 28. 2009
feral Emergency Management Agency / C
ional Floo nsurance Program Important. Read the instructions on pages 1-8, 1-01— O 39 a
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
0-0 U2505 Policy Number
1. Building Owner's Name
2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
565 FOREST VIEW CIRCLE
City DANIA BEACH State FL ZIP Code 33021
3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
ORTION OF PARCEL 5, FOREST VIEW ESTATES PLAT(175/182-183)A.K.A. LOT 1
.4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL Horizontal Datum: ❑ NAD 1927 ® NAD 1983
5. Latitude/Longitude: Lat.26°02'54"N Long.80°11'341N
,6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
,7. Building Diagram Number 1
�8. 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) NIA sq ft a) Square footage of attached garage 471 sq ft
b) No.of permanent flood openings in the crawl space or b) No,of permanent flood openings in the attached garage
enclosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above.adjacent grade 8
c) Total net area of flood openings in A8.b NIA sq in c) Total net area of flood openings in A9.b 360 sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
31.NFIP Community Name&Community Number [BROW�ARD
me FL.State
JNINCORPORATED AREA 1250937� FL
B4.Map/Panel Number B5.Suffix B6,FIRM Index B7.FIRM Panel B8. Flood B9. Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12011 C 0308 F 10/2197 8/18/92 "X" N/A
10. 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)
11. Indicate elevation datum used for BFE in Item B9: ®NGVD 1929 ❑NAVD 1988 ❑Other(Describe)
12. is the building located in a Coastal Barrier Resources System(C RS)area or Otherwise
OPA Protected Area(OPA)? ❑Yes ®No
Designation Date
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
1. 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.
2. 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-g
below according to the building diagram specified in Item AT
Benchmark Utilized Vertical Datum
Conversion/Comments
Check the measurement used.
Top of bottom floor(including basement,crawl space,or enclosure floor)_ 9.3 ®feet ❑meters(Puerto Rico only)
b) Top of the next higher floor 21.7 ®feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) NA ❑feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) 8.5 ®feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 2.1 ®feet ❑meters(Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent(finished)grade(LAG) $.2 ®feet meters(Puerto Rico only)
g) Highest adjacent(finished)grade(HAG) 8.8 ®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.
1 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.
Certifier's Name JERALD A.McLAUGHLIN License Number 5269
Title PRESIDENT Company Name McLAUGHLIN ENGINEERING COMPANY
Ad s 40 E 3 AVENUE City FORT LAUDERDALE State FL ZIP Code 33301
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Signal_ Date 8/30I07 Telephone 954.763.7611
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