Loading...
HomeMy WebLinkAbout325-349 Bryan Rd ' Ei'ARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE / OMB No. 1660 )OO ,trai Emergency Management Agency V Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Policy Number Broward International Commerce Park. LTD Partnership A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route aryryl� o No. ..,.V I 0 Company NAIC Number 325 - 349 Bryan Road (Building #500 ) 0d-7)-0) City ........~State /2,O,. `b,=.. n ZIP Code Dania Florida V"" O _33004 gay/ice A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Portion 4f land in Tract A, Hollywood _Pa1IDReamended, PB 36, Pg. 46 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Non-residential A5. Latitude/Longitude:Lat. 2 6°0 3 r 3 0 . 5 rr N. Long. 8 0°0 9 ' 2 6 .7 rr W. Horizontal Datum: ❑NAD 1927 E 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 1 A A8. For a building with a crawispace 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 ft b) No.of permanent flood openings in the crawispace or b) No,of permanent flood openings in the attached garage 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 a No SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1.NFIP Community Name&Community Number B2.County Name 83.State Dania, City of 120034 Broward Florida B4. Map/Panel Number 85.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone 1 2 01 1 C 0 3 0 6 F Date Effective/Revised Date Zone(s) AO,use base flood depth) 10/2/97 Aug. 19 , 1992 AE 7 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89. ❑FIS Profile E FIRM Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item 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 a No Designation Date _ ❑CBRS ❑OPA 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. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/A0. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized #2041 -Broward County System Vertical Datum NGVD 1929 Conversion/Comments Check the measurement used. 8 0 a) Top of bottom floor(including basement,crawlspace,or enclosure floor) j feet meters(Puerto Rico only) b) Top of the next higher floor N/A L-I 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 ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building Z. 7 ®feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 4. 0 uo feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 7.9_®feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including 4. 042 feet ❑meters(Puerto Rico only) structural support 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 he punishable by fine or imprisonment under 18 U.S. Code, Section 1001. E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? [ Yes ❑ No Certifier's Name License Number Bruce N. Carter 2963 Title Company Name L%G _-. ._.. President Bruce Carter & Associates, Inc. _ Address City State ZIP Code 409 -R_ -fi AvP_ Delray Beach L ----33483 - PSM #2963 Signature Date Telep one 8/11 /10 5h1 -2h -1910 , 2010 FEMA F 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding Information from Section A. For Insurance Company U=s— -w1 Building Street Address(including Apt.,Unit,Suite, and/or Bldg.No.)or P.O.Route and Box No. - 325 - 349 Bryan Raad Policy Number City State Dania FL ZIP 3 Code 0 4 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 C2.e) = FPL pad * C2 . f) & C2 .h) = truck bay Signature —/ Date 8/1 1 /1 0 E Check here if attachments SECTIO -BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. 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 ❑below the HAG. feet ❑meters above or b)Top of bottom floor(including basement,crawlspace,or enclosure)is Elf eet meters Eabove or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided In Secti A Items 8 and/or 9(see a es 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is . ❑feet U j meters ❑above or L j 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 ❑ feet ❑meters ❑above or ❑below 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 and G9. 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 G2. ❑ is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G3. EA community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. The following information(Items G4-G9)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(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site ❑feet ❑meters(PR) Datum G10.Community's design flood elevation ❑feet meters(PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions r' >. Building Photographs . See Instructions for Item A6. For Insurance Company Use.—I iBuilding Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number 325 — 349, Bryan Road (Building #500) City State ZIP Code Company NAIC Number Dania Florida 33004 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page, following. • h RIGHT SIDE LEFT FRONT m 1 , - MIfT ■ ■ ■I um ,1, a h 1 ... I i 1-., LEFT SIDE RIGHT FRONT V • .2 y'4