HomeMy WebLinkAbout1201 Stirling Rd U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal_mergency Management Agency Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A PROPERTY INFORMATION For Insurance Company Us-.:
Al. Building Owner's Name CITY OF DANIA WATER TREATMENT PLANT(MEMBRANE BLDG) Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number
1201 STIRLING ROAD
City DANIA BEACH State FL ZIP Code 33004
gio- sly
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)PORTION OF SECTION 4 TOWNSHIP 51 S., RANGE 42 E. //)0 1,J_ OO_ DO'O
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.)PLANT BLDG.
A5. Latitude/Longitude: Lat. N.26°02'52.47" Long.W.80'09'11.92" Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number 1A
A8. For a building with a crawlspace 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 crawlspace 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 A8.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 BJ No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name B3.State
CITY OF DANIA 120034 BROWARD FLORIDA
B4. Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevztion(s)(Zone
0308 F Date Effective/Revised Date Zone(s) AO, use base flood depth)
08-18-92 08-18-92 AE 7.0
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® 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 ® 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,ARIA,AR/AE,AR/Al-A30,AR/AH,AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized "SEE COMMENTS" Vertical Datum 7.16 NGVD 1929
Conversion/Comments
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)8.5 ®feet ❑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 ❑ meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑ meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.3 ®feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 8.3 ®feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑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. l certify that the information on this Certificate represents my best efforts to interpret the data available.)
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. Were latitude and longitude in Section A provided by a
licensed land surveyor? ® Yes ❑ No
Certifier's Name ROBERT A. BUGGEE License Number 3302 .
Title SURVEYOR/MAPPER Company Name BOB BUGGEE, INC. ^', `
: �_t,,, gTAtc or-
Address 33 E. TEWAY VD City BOYNTON BEACH State FL ZIP Code 33435
Signatu Date 1-20-12 Telephone 561-732-7877 r'n'
FEMA Form 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 Usr:
Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number
1201 STIRLING ROAD
City POMPANO 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)community official,(2)insurance agent/company,and(3)building owner.
Comments Building is for Water Plant. Benchmark is Catch Basin Rim @ NS E Corner of Building Elevation 7.16 N G V D 1929
see also final as built survey.
Signature Date 01-20-12
❑ Check here if attachments
SECTION E-BUILDING ELEVATION IN TION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1-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 ❑feet ❑ meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ 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 higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑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, 8, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
ROBERT A. BUGGEE
Address 233 E. G AY BLVD. City BOYNTON BEACH State FL ZIP Code 33435
Signature Date 01-20-12 Telephone 561-732-7877
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
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building 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 G5. Date Permit Issued
G6. Date Certificate Of Compliance/Occupancy Issued
------------
G7. This permit has been issued for:
❑ New Construction El Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building:
G9. BFE or(in Zone AO)depth of flooding at the building site: feet El meters(PR)Datum
G10. Community's design flood elevation ❑feet ❑meters(PR)Datum
❑feet ❑meters(PR)Datum
Local Official's Name
Community Narne Title
Telephone
Signature
_ Date
co�C meests ---
❑Check here if attachments
FEMA Form 81-31, Mar 09 Replaces all previous editions
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency Management Agency Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A9. Building Owner's Name CITY OF DANIA WATER TREATMENT PLANT(MEMBRANE BLDG) Policy Number
A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number
1201 STIRLING ROAD
City DANIA BEACH State FL ZIP Code 33004
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
PORTION OF SECTION 4 TOWNSHIP 51 S.,RANGE 42 E.
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.)PLANT BLDG.
A5. Latitude/Longitude:Lat. N.26°02'52.47" Long.W.80'09'11.92" Horizontal Datum: ❑ NAD 1927 E NACU 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1A
A8. For a building with a crawlspace 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 crawlspace 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 A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑ Yes E No d) Engineered flood openings? ❑ Yes E No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name 83.State
CITY OF DANIA 120034 BROWARD FLORIDA
B4. Map/Panel Number B5.Suffix B6.FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevations)(Zone
0308 F Date Effective/Revised Date Zone(s) AO,use base flocd depth)
08-18-92 08-18-92 AE 7.0
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other(Describe)
1311. Indicate elevation datum used for BFE in Item B9: E 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 E No
Designation Date ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction" E 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,V1430,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item AT Use the same datum as the BFE.
Benchmark Utilized "SEE COMMENTS" Vertical Datum 7.16 NGVD 1929
Conversion/Comments
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)8.5 E feet ❑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 ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.3 E feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 8.3 E feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑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. /certify that the information on this Certificate represents my best efforts to interpret the data available.)
understand that any false statement may be 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? E Yes ❑ No o ,
Certifier's Name ROBERT A. BUGGEE License Number 3302 Z,
Title SURVEYOR/MAPPER Company Name BOB BUGGEE, INC.
Address 33 E. TEWAY VD City BOYNTON BEACH State FL ZIP Code 33435
Signatu Date 1-20-12 Telephone 561-732-7877
FEMA Form 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 Ust.:
Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number
1201 STIRLING ROAD
City POMPANO 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)community official,(2)insurance agent/company,and(3)building owner.
Comments Building is for Water Plant.Benchmark is Catch Basin Rim @ NS E Corner of Building Elevation 7.16 N G V D 1929
see also final as built survey.
SignatureEan_��� Date 01-20-12
❑ Check here if attachments
SECTION E-BUILDING ELEVATION IN TION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1-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.
E1. 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 ❑feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ 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 higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters [I above or ❑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 Elfeet Elmeters Elabove or E]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
ROBERT A. BUGGEE
Address 233 E. G AY BLVD. City BOYNTON BEACH State FL ZIP Code 33435
Signature Date 01-20-12 Telephone 561-732-7877
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
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building 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 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:
G9. BFE or(in Zone AO)depth of flooding at the building site: El feet El meters(PR)Datum
G10. Community's design flood elevation ❑feet ❑meters(PR)Datum
❑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
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U.S DEPi)RTA11ENT OF HOMELAND SECURITY �:.VATION CERTIFICATE OMB No. 1660-0008
Fcadera.r Eak Mcy Ma0agement Agency l Expires March 31, 2012
National Flood t;isurance Program Important: Read the instructions on pages 1-9. J
SECTION A-PROPERTY INFORMATION For Insurance Company Use.
Al. Building Owner's Name WEST CONSTRUCTION Policy Number
A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Company NAIC Number
1201 STIRLING ROAD
City DANIA BEACH State FL ZIP Code 33020
A3. Property Description(Lot and Block Numbers,Tax Parcel Number. Legal Description,etc.)
4-51-42 1 10 t 1d QLI-00-ool 0
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude: Lat. N.26°02'53.95" Long.W.80°09'06.14" Horizontal Datum: ❑ 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 1A
A8. For a building with a crawlspace 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 15000 sq ft
b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage
enciosure(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 A8.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 ® No i
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2.County Name 63.State - -
CITY OF DANIA BEACH 120034 I BROWARD _ FLORIDA
B4. Map/Panel Number B5. Suffix 1 B6. FIRM Index 67. FIRM Panel B8. Flood 69. Base Flood Elevation(s)(Zone
120034 0308 F j Date I Effective/Revised Date Zone(s) AO, use base flood depth)
10-02-97 08-18-92 AE 7 FEET
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other(Describe)
Bl 1. 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 ® No
Designation Date _ ❑ CBRS ❑ OPA
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. 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/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized "SEE COMMENTS" Vertical Datum 6.36 NGVD 1929
Conversion/Comments
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)8.5 ®feet ❑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) 8_5. ❑feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 8.4 ®feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.0 ®feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 8.5 ®feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑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. /certify that the information on this Certificate represents my best efforts to interpret the data available.I
understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a !�N�p`G• ,.•.. C; r
licensed land surveyor? ® Yes El No cri �Q iFtCATi+�`�
Certifier's Name ROBERT A. BUGGEE License Number 3302q' V Na•33a2
Title SURVEYOR/MAPPER Company Name BOB BUGGEE, INC. STATF,OF
� S
o., a, ..� on •
Addre 233 GATEW LVD. City BOYNTON BEACH State FL ZIP Code 33435 `'s;•••.,�omv!": a
Signatu Date 07-07-10 Telephone 561-732-7877 dPF' vUrve�iU� }�^
,r,sP; I,Iy�l+
FEMA Form 81-31, Mar 09� +` See reverse side for continuation. Renlacac all nrowin- orliti
IMPORTANT: In these spaces, cop :corresponding information from Section, For Insurance Compa*,-7
Budding Street Address(including Apt.. Unit, Suite. and/or Bldg. No.)or P.O. Route and Box No. Policy Numbe'
1201 STIRLING ROAD
City DANIA BEACH State FL ZIP Code 33020
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 MACHINERY-TOP OF AIR CONDITIONER PAD AND GENERATOR ELEVATION 8.4 FEET BENCHMARK-NORTHWEST
PROPERTY CORNER CAT H BASIN ELEVATION 6.36 FEET NGVD 1929 LAT/LONG-HAND HELD GPS UNIT
Signature Date 07-06-10
❑ Check here if attachments
SECTION F BUILDING DING ELEVATION INF4F i TION (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 ❑feet ❑meters El above or❑below the HAG.
b)Top of bottom floor(including basement, crawlspace, or enclosure)is ❑feet ❑meters
❑above or 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),he next higher floor
(elevation C2.b in the diagrams)of the building is [:1 feet ❑meters E]above or ❑below the HAG.
E3. Attached garage(top of slab)is
❑feet El meters ❑above or El below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters El above or El 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 statemGi-1 s in Sections A, B,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
ROBERT A. BUGGEE
Address 233 E.GATEWAY BLVD, City BOYNTON BEACH State FL ZIP Code 33435
Signature Date 07-06-10 Telephone 561-732-7877
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
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building 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 _TG5 Date Permit Issued G6. Date Certificate Of Compha�ncelOcc�upanc, ssued
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
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address(including Apt, Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number
1201 STIRLING ROAD
City DANIA BEACH State FL ZIP Code 33020 Company NAIC Number
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.
"FRONT VIEW"
07-06-10
.II
"REAR VIEW"
07-06-10
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