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HomeMy WebLinkAbout200 NE 2 Ave u.S.DEPARTMENT OF HOMELAND SECURi'Y tLtVA I IUN l.ttl I ihil.A I C OMB No 1660-0008 4 FEf ERA(.EMERGENCY MANAGEMENT AGENCY iu.rtai Flood Insurance Program Important: Read the instructions on pages 1-9, Expiration Date July 31. 20115 SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE Building Owner's Name Policy Number -2 Building Street Address(including Apt.,Unit, Suite,and/or Bldg No)or P 0 Route and Box No Company NAIG Number 200 NE 2"'°AVENUE City DANIA BEACH State FL ZIP Code 33004 "` ! 7 2 - A3. Property Description(Lot and Block Numbers.Tax Parcel Number.Legal Description etc) ` . • LOT 13 BLOCK 1.FLORIDA VILLAGE HEIGHTS, P B 89, PG.22. 8 C R / A4 Building Use(e.g.. Residential.Non-Residential. Addition, Accessory. etc)RESIDENTIAL A5 Latitude/Longitude Lat. 26403"21"W Long 80^08"29"W Honzontal Datum 0 NAD 1927 ® NAD '983 A6 Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance A7 Building Diagram Number 1 B A8 For a building with a crawlspace or enclosure(s) A9 For a building with an attached garage a. Square footage of crawispace or enclosure(s) NA sq ft al Square footage of attached garage 528 sq ft c' Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s)within 1 0 foot above adjacent grade NA within 1 0 foot above adjacent grade 0 Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9 b C so it d) Engineered flood openings' 0 Yes ® Nc d) Engineered flood openings% 0 Yes © Nc SECTION B- FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81 NFIP Community Name&Community Number 1 82.County Name B3 State DANIA.BEACH 120034 I BROWARD FLORIDA 84 Map,Panel Number B5. Suffix 1 B6 FIRM Index Date I 67. FIRM Panel B8 Flood , B9 Base Flood Elevationtsi(Zone 12011C 0309 F 8118192 I Effective/Revised Date I Zone(s) AC,use base flood depth) 10;02197 I AE 7' 310 Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89 Ci FIS Profile ® FIRM 0 Community Determined ❑ Other;Source 5 . •ndicate elevation datum used for BFE in Item B9 ® NGVD 1929 ❑ NAVD 1988 0 OtherrSource _____ ?'2 Is the building located in a Coastal Barney Resources System(CBRS)area or Otherwise Protected Area(OPA)"o 0 'Yes o Designation Date ,,. 0 CBRS 0 OPA SECTION C - BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) CI Building elevations are based on 0 Construction Drawings' 0 Building Under Construction' 0 Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete 02 Elevations-Zones AI-A30,AE,AH,A(with BFE),VE,VI-V30,V(with BFEi,AR,ARIA ARiAE,AR/A1-A30,ARIAH,AR'AO Complete Items C2 a-n below according to the building diagram specified in Item A7 In Puerto Rico only.enter meters Benchmark Utilized SEE COMMENTS Vertical Datum Indicate elevation datum used for the elevations in items a)through h)below. ® NGVD 1929 0 NAVD 1988 0 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..crawispace.or enclosure floor) $4S 0 feet 0 meters b) Top of the next higher floor NA._ ®feet 0 meters Bottom of the lowest horizontal structural member(V Zones only) NA 0 feet 0 meters d Attached garage(top of slab) 7 45 ®feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 7.75 ®feet 0 meters ;Describe type of equipment and location in Comments) fi Lowest adjacent(finished)grade next to building(LAG) 7 3 ®feet 0 meters gi Highest adjacent(finished)grade next to building(HAG) 7.75 ®feet 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs.including structural support ❑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 elevat.on r— ie / information I certify that the information on this Certificate represents my best efforts to interpret the data available r understand that any false statement(nay be punishable by fine or imprisonment under 18 U S. Code. Section 1001 <-:-A„/7'"` Check here if comments are provided on back of form Were latitude and longitude in Section A provided b':a . Check here if attachments. licensed!and surveyor ® Yes 0 No j r:� ( ( ,:� Cerrtiffier's Name ERNEST W DUNCAN License Number 5182 Title LAND SURVEYOR Company Name ERNEST DUNCAN,P S.M 5182 - - ?� ' / Address 521 SE 5T'COURT City POMPANO BEACH State FL ZIP Code 33060 Signature C-:>2 ic_i_____ Date 3/6/14 Telephone 754 264 2166 IMPOPTPNT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE P andPolicyNumber BuilLting Street Address(including Apt.,Unit,Suite, andlor Bldg No; orRoute Box No fl0 NE 2"o AVENUE _ _ City DAMJIA BEACH State FL ZIP Code 33004 Company NAIC Number — SECTION D-SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1 i community official.(2)insurance agent:company. and(3)building owner Comments A5)G00GLE EARTH C2e)AIR CONDITIONER BENCHMARK-RIM OF MANHOLE AT INTERSECTION OF NE 2"0 AVE& NE 2'PLACE Cna:.iree't Date 31614 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFEi.complete Items El-E5 If the Certificate is intended to support a LOMA or LOMR-F request complete Sections A. E 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 fer the following and check the appropriate boxes to showwhether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAGi a)Top of bottom floor(including basement. crawispace.or enclosure)is ,_ __ ❑ feet 0 meters ® above or 0 below the HAG bi Top of bottom floor(including basement.crawispace or enclosure)is __ ❑ feet 0 meters 0 above or 0 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 nigher floor elevation C2.b in the diagrams)of the building is 0 feet 0 meters ❑above or 0 below the HAG E3 Attached garage(top of slabi is _ 0 feet 0 meters 0 above or 0 below the HAG E4 Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters 0 above or 0 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 managerier ordinance? 0 Yes 0 No 0 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 authonzed 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 Owners Authorized Representative's Name __._ State City ZIP Code Signature Date Telephone Comments 0 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 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 0 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 I G2 0 A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AC G3 0 The following information(Items G4-G10)is provided for community floodplain management purposes __ G4 Permit Number G5. Date Permit Issued i G6. Date Certificate Of Compliance/Occupancy Issued G7 This permit has been issued for ❑ New Construction 0 Substantial Improvement '..;8 Elevation of as-built lowest floor(including basement)of the building 0 feet 0 meters Datum i G9 BFE or(in Zone AO)depth of flooding at the building site __- 0 feet ❑meters Datum 1 G10 Community's design flood elevation 0 feet 0 meters Datum _ i Local Official's Name Title Community Name Telephone Signature Date Comments_ . -0 Check here if Eifi) DANIA BEACH SEA IT LIVE IT LOVE IT Memo of Review for Accuracy and Completion The attached FEMA Elevation Certificate has been reviewed by this office. The items noted below are not correct on the attached form and should read as entered on this page. SECTION A-PROPERTY INFORMATION � 7NStlGftliYfyNX #�S Al. Building Owner's Name A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. `f33fii0144l42a� � L 200 NE 2 Avenue City State ZIP Code A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑NAD 1927 0 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 A8. For a building with a orawlspace or enclosure(s): A9.For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) _ sq ft a) Square footage of attached garage -sq f: b) No.of permanent flood openings in the crawispace or b) Number of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade _ within 1.0 foot above adjacent grade c) Total net area of flood openings In AB.b ___.__.__._. sq in c) Total net area of flood openings in A9.b _sq in d) Engineered flood openings? ❑Yes 0 No d) Engineered flood openings? ❑Yes 0 No SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name&Community Number 62. County Name B3.State B4. Map/Panel Number 85. Suffix B6.FIRM Index Date B7. FIRM Panel Effective/ 88.Flood Zone(s) B9. Base Flood Elevation(s)(Zone Revised Date AO,use base flood depth) 08-18-92 B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered In Item B9: Q flS Profile ❑FIRM ❑Community Determined ❑Other/Source: e11.Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 ❑NAVD 1988 0 Other/Source: B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date: / / ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* ❑Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. Local Official's Name Eleanor Norena Title Community Development Operations Manager Community Name City of Dania Beach Telephone (954) 924-6805 x3645 Signature Date 9d t 1 a �y � O Comments Correction to B7