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U.S.DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 ELEVATION CERTIFICATE Expires February 28.2009
Federal Emergency Management Agency
National Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
Al. Building Owner's Name PEI Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
409 PHIPPEN ROAD City DANIA BEACH State FL ZIP Code 330196-0 /-0(.1'Qap
s')1b
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) L�0 ; /n Q?. 3�-�Q�
SOUTH 25'OF LOT 2,ALL OF LOT 3,BLOCK 1,COLLEGE TRACT,22/10d J
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) NON-RESIDENTIAL
A5. Latitude/Longitude: Lat.26*02'35" Long.80*08'57" Horizontal Datum: 0 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 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) 0 sq ft a) Square footage of attached garage 0 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 0 walls within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 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 FLORIDA
B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO, use base flood depth)
12011C 0308 F 10-02-97 08-18-92 X 0
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
0 FIS Profile ® FIRM ❑ Community Determined El 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)? DYes ®No
Designation Date 0 CBRS ❑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 Al-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 BCE BM#1132 Vertical Datum NGVD 29
Conversion/Comments NA
Check the measurement used.
a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 10.9 ®feet 0 meters(Puerto Rico only)
b) Top of the next higher floor NA. ❑feet 0 meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) NA. ❑feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) NA. ❑feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building NA. ❑feet ❑meters(Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent(finished)grade(LAG) 10.7 ®feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade(HAG) 10.8 ®feet 0 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. /certify that the information on this Certificate represents my best efforts to interpret the data available. i
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.
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Certifier's Name PAUL J.STOWELL License Number 5241 �.
Title PROFESSIONAL SURVEYOR Company Name ATLANTIC COAST SURVEYING INC. 32ti
Address 612 TIRLI ROAD City DAVIE State FL ZIP Code 33314 (��1/ar
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S•, - /inir `_' •:te 04/15/08 Telephone 954-587-2100
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FEMA Form 81-31,February 2006 See reverse side for continuation. Replaces all previous editions