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Home My WebLink About218 NW 7 Ave FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2001! ELEVATION CERTIFICATE Important Read the instructions on pages 1-7. SECTION A-PROPERTY OWNER INFORMATION For insurance Company Use BUILDING OWNER'S NAME Policy Number H.ANTHONY ROLLE BUILDING STREET ADDRESS(Including Apt..Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 218 NW 7'AVENUE CITY STATE ZIP CODE DANIA BEACH FL 33004 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 15,BLOCK 5,MAP OF THE TOWN OF MODELO.PLAT BOOK B.PAGE 49,DADE COUNTY,FLORIDA BUILDING USE(e g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary) RESIDENTIAL LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE ❑GPS(Type): or #t#.## ##°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ®Other:NGVD SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61 NFIP COMMUNITY NAME&COMMUNITY NUMBER B2 COUNTY NAME B3 STATE CITY OF DANIA BEACH 120054 BROWARD FLORIDA B4 MAP AND PANEL B7 FIRM PANEL B9_BASE FLOOD ELEVATIONS) NUMBER B5 SUFFIX B6 FIRM INDEX DATE EFFECTIVE/REVISED DATE B8 FLOOD ZONE(S) (Zone AO use depth of fioodng) 0309 F 10-02-97 08-18-92 '"X" N/A B10 Indicate the source of the Base Flood Elevation(BFF)data or base flood depth entered in B9. ❑FIS Profile ®FIRM ❑Community Determined ❑Other(Desaibe) B11 Indicate the elevation datum used for the BFE in B9 E NGVD 1929 ❑NAVD 1988 ❑Other(Describe) B12.Is the building located in a Coastal Bami—, Resources System(CBRS)area or Othenimm Protected Area(OPA)?E]Yes E No Designation Date_ SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) CI.Building elevations are based on'.❑Construction DrawnV ❑Buidng Under Construction' ®Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2.Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed-se°pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) C3.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,ARIAO Complete Items C3.-a-i below according to the building diagram specified in Item C2.State the datum used.If the datum is different from the datum used for the BFE in Section B,convert the datum to that used for the BFE.Stow Wd measurements and datum cmvemon calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion. Datum Conversion/Canments_ Elevation reference mark used X Does the elevation reference mark used appear on the FIRI ❑Yes No , * a)Top of bottom floor(inducing basement or enclosure) 11. 10 ft.(m) _ * b)Top of next higher floor N/A._ft(m) . ' u c)Bottom of kxvest hor¢ontal structural m (J zones only) WA. W o d)Attached garage(top of slab) 10. 45 ft(m) W CU o e)Lowest elevation of machinery and/or equipment 3l servicing the bulking(Desarbe in a Comments area) 10.50 tt(m) E ti o f)Lowest adjacent(finished)grade(LAG) 9.90 ft(m) Z.2 3 Q J o g)Highest adjacent(finished)grade(HAG) 10. 15 fL(m) o h)No,of permanent openings(flood vents)v&w 1 it above adjacent grade NIA o )Total area of all permanent openings(flood vents)in C3.h N/A sq.in.(sq.an) 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. 1 certify that the information in Sections A.,B,and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement,nay be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. CERTIFIERS NAME PILAR SOLER LICENSE NUMBER 6310 TITLE PROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME PSM&ASSOCIATES,P.A. LB# 7149 ADDRESS CITY STATE ZIP CODE 311 NW 136TM AVENUE MIAMI FL 33182-1952 SIGNATURE � DATE TELEPHONE 05 29-03 305-226-0334 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 218 NW 7TH AVENUE CITY STATE ZIP CODE Company NAIC Number DANIA BEACH r� 33W4 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)oommunity official,(2)insurance agent/company,and(3)building owner. COMMENTS CRW!N ELEVATION: 9.86' BENCH MARK USED: Bfv1 AT THE INTERSECTION OF NW 7TH AVENUE AND 3F2 STREET,MANHOLE RIM ELEVA T ION: 10.32' AIR CONDITIONER/CONCRETE SLAB ELEVATION 10.50' ELEVATION CERTIFICATE FOR FINAL ❑Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(iMTHOUT BFE) For Zone AO and Zone A(without BFE),complete Items E1 through E4 If the Eievation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed El Building Diagram Numloer_(Select the buildng diagram most similar to the building for which this certificate is being completed—see pages 6 and 7 If no diagram accurateh, represents the building,provide a sketch or photograph.) E2 The top of the bottom floor(including basement or enclosure)of the building is_fL(m)_in.(c m)❑above or ❑below(check one)the highest adjacent grade. (Use natural grade if available) E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(crn)above the highest a4acent grade. Complete items C3.h and C3.i on front of form. E4 The top of the platform of machinery ardor equQrnent servicing the building is_ft.(m)_in,(cm)❑above or ❑below(check one)the highest adpcent grade (Use natural grade,9 available). E5 For Zone AO only: If no flood depth number Is avaiable,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 C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community- issued BFE)or Zone AO must sign here. The stateme1s in Seciom A.8.C.are E we correct to rite best of my farowledge. 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 autt aized by law or orrinance 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. G1.❑The information in Section C was taker.,from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state or local Ow to certify elevator information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑A community official completed Section E for a buildng located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑The following information(Items G4-G9)is provided for community floodplain management purposes. G4 PERMIT NUMBER i Chi 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-buih lowest floor(inducing basement)of the b0dng is: _ft.(rn) Datum: G9.BFE or(in Zone AO)depth of flooding at the building site is: _._ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check here if attachments