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Home My WebLink About634 NE 3 St c'r)ERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 .JATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200E ELEVATION CERTIFICATE19 j Important: A�3' �6 Read the instructions on pages 1-7. , SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME 423�J'(� ��2 Policy Number RONALD BROZIC BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE ANIP BOX NO. Company NAIC Number 634 N.E.3"D STREET CO 112�2oo� 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 1,ROYAL PALM VISTA EAST(P.B.90-6 B.C.R.) 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 ##.#####I ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE CITY OF DANIA BEACH-120034 BROWARD FLORIDA B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVAT ON(S) NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone AO,use depth of floc ding) 12011CO309 F 10-2-97 8-18-92 AE 7.0 B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. ❑AS Profile ®FIRM ❑Community Determined ❑Other(Describe): B11.Indicate the elevation datum used for the BFE in B9:®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 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,Vt-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO Complete items C3.-a-i 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 COUNTY Conversion/Comments Elevation reference mark used N/A Does the elevation reference mark used appear on the FIRM? ❑Yes ®No ❑a)Top of bottom floor(including basement or enclosure) 8. 1 ft.(m) cu ❑ b)Top of next higher floor N/A._ft.(m) ❑c)Bottom of lowest horizontal structural member(V zones only) N/A._ft.(m) 00 ❑ d)Attached garage(top of slab) 7. 4 ft.(m) E ❑ e)Lowest elevation of machinery and/or equipment �r servicing the building(Describe in a Comments area) 7.2 ft.(m) E m f ❑f)Lowest adjacent(finished)grade(LAG) 6.7 ft.(m) Z in ti� ❑g)Highest adjacent(finished)grade(HAG) 7. 4 ft.(m) ❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade N/A ❑ i)Total area of all permanent openings(flood vents)in C3.h NIA 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 maybe punishable by fine or imprisonment under 18 U.S.Code,Section 1001. CERTIFIER'S NAME STEPHEN H.GIBBS LICENSE NUMBER 4054 TITLE PRESIDENT COMPANY NAME GIBBS LAND SURVEYORS ADDRESS CITY STATE ZIP CODE 2131 HOLLYWOOD BOULEVARD.SUITE 201 HOLLYWOOD FL 33020 _ SIGNATURE u Jl DATE TELEPHONE 08-20-03 954-923-7666 FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresowding information from Section A — For In;,-,ance company use: a BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and d.No.)OR P.O.ROUTE AND BOX NO. Policy Number 634 N.E.3RD STREET CITY STATE ZIP CODE Company NAIC Number CITY OF DANIA BEACH FL 33004 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. COMMENTS ❑Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(IMTHOUT BFE) For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. Ell.Building Diagram Number_(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.) E2.The top of the bottom floor(including basement or enclosure)of the building is _ft.(m)_in.(crn)❑above or ❑below(check one)the highest adjacent grade. (Use natural grade,if available). E3.For Building Diagrams 6-8 with openings(seepage 7),the next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4.The top of the platform of machinery and/or equipment servidng the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use natural grade,if available). E5.For 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 ❑No ❑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,C(Items C3.h and C3.i only),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,C,and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑Check here 9 attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local offical 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. Corr:olete the applicable item(s)and sign below. G1.❑The information in Section C was taker,from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state or for al law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑The following information(Items G4-G9)is provided for community floodplain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED 36. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7.This permit has been issued for. ❑New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building is: _._ft.(m) Datum: G9.BFE or(in Zone AO)depth of flooding at the building site is: __ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check here 9 attachments FEMA Form 81-31,January 2003 Replaces all previous editions