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[IS,DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Fede,A mergency Management Agency Expires February 28.2009
tonal Flood Insurance Program Important: Read the instructions on pages 1-8. 62.--Zcj /6 _ 60 yJ
SECTION A-PROPERTY INFORMATION For Insurance Company L'se:
Al. Building Owner's Name BROWARD COUNTY POLICE BENOVELENT ASSOC. Policy Number
A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Company NAIC Number
2901 S.W.26T"TERRACE
City DANIA BEACH State FL ZIP Code 33312
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
PORTION OF PARCELS'A'&'B',COUNTRY BARBEQUE CABIN(P.B.90,PG.7,B.C.R.)
A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) COMMERCIAL
A5. Latitude/Longitude: Lat.26°05'06" Long.80°10'36" Horizontal Datum: D NAD 1927 ® '4AD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1
A8. 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) N/A sq ft a) Square footage of attached garage N/A 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 N/,4
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
B1. NFIP Community Name&Community Number B2.County Name B3.State
DANIA BEACH 120034 BROWARD FL
B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8. Flood B9,Base Flood Elevations)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12011C0306 F 10-02-97 08-18-92 AE 8.0
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
0 FIS Profile ® FIRM 0 Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item B9: ®NGVD 1929 0 NAVD 1988 ❑Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes E No
Designation Date ❑CBRS 0 OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑Construction Drawings* 0 Building Under Construction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-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 A7.
Benchmark Utilized COUNTY Vertical Datum NGVD
Conversion/Comments
Check the measurement used.
a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ $.0 ®feet 0 meters(Puerto Rico only)
b) Top of the next higher floor N/A._ ❑feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) N/A._ ❑feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) N/A. ❑feet_ 0 meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 7.9 0 feet ❑meters(Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent(finished)grade(LAG) 6.3 ®feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade(HAG) 7.3 0 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. 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.
0 Check here if comments are provided on back of form.
PL ACE
Certifier's Name STEPHEN H.GIBBS License Number 4054
HER i°
Title PRESIDENT Company Name GIBBS LAND SURVEYORS
Address 2131 HWD.BLVD.,STE.204 City HOLLYWOOD State FL ZIP Code 33020
Signature • k Date 08-15-07 Telephone 954-923-7666