HomeMy WebLinkAbout2611 SW 54 St (2) U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
VaaonalT-lood Insurance Prograur Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name CHRISTIANE DESORMEAUXO Policy Number:
A2. Building Street Address(including Apt., Unit,Suite, and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number:
2611 SW 54"STREET
City DANIA BEACH State FL ZIP Code 33312
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 9,BLOCK 30,2ND ADDN TO RAVENSWOOD EST&MARINA, PB 72-14, PUBLIC RECORDS OF BROWARD CO. FL.
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory, etc.) MOBILE HOME PARK
A5. Latitude/Longitude: Lat.26003'25" Long.80010'30" 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.
A7. Building Diagram Number 5
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq f
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached ga age
or enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number �BIROWARD
2.Cnty Name B3. State
UNINCORPORATED 125093 FLORIDA
B4.Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9 Base Flood Elevation(s)(Zone
12011 C-0308 F 10-02-1997 Effective/Revised Date Zone(s) AO,use base flood depth)
08-18-1992 "AE" 8 FT
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/Source:
B11. Indicate elevation datum used for BFE in Item 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date: N/A ❑ 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,ARlAE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters.
Benchmark Utilized: BROW TBM MH EL 5.81' Vertical Datum: NGVD 1929
Indicate elevation datum used for the elevations in items a)through h)below. ® NGVD 1929 El NAVD 1988 El Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 9.28 ®feet ❑ meters
b) Top of the next higher floor N/A. ❑feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters
d) Attached garage(top of slab) NIA. ❑feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 9.01 ®feet ❑meters
(Describe type of equipment and location in Comments)
0Lowest adjacent(finished)grade next to building(LAG) 6.1 ®feet El meters
g) Highest adjacent(finished)grade next to building(HAG) 6.2 ®feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 6.22 ®feet ❑meters
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 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.
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
® Check here if attachments. licensed land surveyor? ® Yes ❑ No
Certifier's Name FILAR SOLER License Number 6310 P,5/L,/1zI
Title PSM Company Name /¢
Address 311 NW 136TH AVENUE City MIAMI State FL ZIP Code 33182-1952
Signature i` ' 1 �Date 02-01-2014 Telephone 305-979-6087
FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
ELEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number:
2611 SW 54TH STREET
City DANIA BEACH State FL ZIP Code 33312 Company NAIC Number:
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 1.-THIS CERTIFICATE IS NOT VALID WITHOUT SIGNATURE AND ORIGINAL RAISED SEAL OF FLORIDA LICENSE OF PSM#6310
2.-THIS CERTIFICATE DEPICTED HEREON IS NOT COVERED BY PROFESSIONAL LIABILITY,
3.-C2.e(LOWEST ELEVATION OF MACHINERY OR EQUIPMENT)AIR CONDITIONER CONCRETE SLAB ELEVATION 9.01'
4.-CROWN ELEVATION 6.07'; 5.-BM USED:TBM A MANHOLE RIM ELEVATION 5.81,
6-LATITUDE AND LONGITUDE DETERMINED BY GPS;7.-PARALLEL SHEAR WALLS.
Signature /� /�� Date 02-01-2014
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SECTION E-BUILDIN(YELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A, B,
and C. For Items E1-E4, use natural grade,if available.Check the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑ meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage(top of slab)is ❑feet ❑ meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is Elfeet Elmeters Elabove or Elbelow the HAG.
E5. 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,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,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 if attachments.
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official 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.Complete the applicable item(s)and sign below.Check the measurement used in Items G8-G10. In Puerto Rico only,enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer, or architect who
is authorized by 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-G10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. 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: ❑feet ❑meters Datum
G9. BFE or(in Zone AC)depth of flooding at the building site. ❑feet ❑meters Datum
G10. Community's design flood elevation: ❑feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments.
FEMA Form 086-0-33(7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 Building Photographs
See Instructions for Item A6.
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number:
2611 SW 54TH STREET
City DANIA BEACH State FL ZIP Code 33312 Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
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Date: 01-29-2014 (Picture taken) Date: 01-29-2014 (Picture taken)
Facing: FRONT VIEW Facing: LEFT SIDE VIEW
Description: PS-1322 FINAL Description: PS-1322 FINAL
Pilar Soler,PISM#6310
Date: 02-01-2014
FEMA Form 086-0-33(7/12) Replaces all previous editions.
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ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number:
2611 SW 54TH STREET
City DANIA BEACH State FL ZIP Code 33312 Company NAIC Number:
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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Date: 01-29-2014 (Picture taken) Date: 01-29-2014 (Picture taken)
Facing: REAR VIEW Facing: RIGHT SIDE VIEW
Description: PS-1322 FINAL Description: PS-1322 FINAL
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Pilar Soler, PSM#6310
Date: 02-01-2014
FEMA Form 086-0-33(7/12) Replaces all previous editions.
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