HomeMy WebLinkAbout609 SW 12 Ave -DERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM — Expires December 31, 200E
ELEVATION CERTIFICATE -3 -o oa
Important: Read the instructions on pages I.7. 8 �Q 0 ��y��(0 0
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Usa:
BUILDING OWNER'S NAME Policy Number
HENRY
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
609 SW 12"'Avenue
CITY STATE ZIP CODE
City of Dania Beach FL 33004
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 2,Block 6-COLLEGE TRACT (19/9)
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 ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 82.COUNTY NAME B3.STATE
City of Dania Beach 120034 Broward FL
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVAT ON(S)
NUMBER B5.SUFFIX B6,FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone AO,use depth offbcding)
12011CO208 F 10/2197 8/18/92 W NIA
B10.Indicate the source 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 89:®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 0 No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.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.Building Diagram Number 1(Select the building diagram 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 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 C3.-a�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 for 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_ Conversion/Comments_
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ®No
a)Top of bottom floor(including basement or enclosure) 11. 3 ft.(m)
b)Top of next higher floor N.A ft.(m) \
c)Bottom of lowest horizontal structural member(V zones only) N.A ft.(m) o
d)Attached garage(top of slab) N. Aft.(m) E� 4 \
e)Lowest elevation of machinery and/or equipmentcu
a \t
servicing the building(Describe in a Comments area) N.A ft.(m) Y\
f)Lowest adjacent(finished)grade(LAG) 10.5 ft.(m) Z
g)Highest adjacent(finished)grade(HAG) 10.P.O , ^^^��\
h)No,of permanent openings(flood vents)within 1 ft.above adjacent grade 0
i)Total area of all permanent openings(flood vents)in C3,h N/A 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.
I understand that any false statement may be punishable by fine or imprisonment under 18 U,S. Code,Section 1001. _
CERTIFIER'SNAME: JERALD A.McLAUGHLIN LICENSE NUMBER: 5269
TITLE: PRESIDENT COMPANY NAME: McLAUGHLIN ENGINEERING COMPANY]
ADDRESS CITY STATE ZIP CODE
400 JW McLaughlin Ave(NE 3b AVe Fort Lauderdale FL 33301
SIGNA DATE TELEPHONE
4/5/04 954.763.7611
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions