HomeMy WebLinkAbout4448 SW 27 Ave U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGEd`JCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31,2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name JENSEN,RICHARD W&MIMI ANN U9624 Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number:
4448 SW 27 AVENUE
City DANIA BEACH State FL ZIP Code 33312
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
PORTION OF LOT 10,BLOCK 4 MARSHALLS EVERGLADE SUB(2/32)SECTION 29-50-42 AKA LOT 30 MP
A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude: Lat.26°04'00.3"N Long.80°10'34.9"W Horizontal Datum:, ❑ NAD 1927 Z 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 crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage - sq ft
b) 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 0 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
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
B1.NFIP Community Name&Community Number B2.County Name B3.State
DANIA BEACH 120034 BROWARD FL
B4. Map/Panel Number B5.Suffix B6. FIRM Index Date B7.FIRM Panel B8. Flood B9.Base Flood Elevation(s)(Zone
12011C 0558 H 8/18/14 Effective/Revised Date Zone(s) AO,use base flood depth)
8/18/14 "X"&"AH" N/A&5'
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/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes Z No
Designation Date: N/A ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction* Z Finished Construction
"A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones A1-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. In Puerto Rico only,enter meters. •
Benchmark Utilized:SEE COMMENTS Vertical Datum: NAVD1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 1E1 NAVD 1988 ❑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) 5.43 ®feet ❑meters
b)Top of the next higher floor N.A ❑feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) N.A LI feet ❑meters
d)Attached garage(top of slab) 4.80 ®feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building 4.87 Z feet LI meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 4.20 ®feet ❑meters
g) Highest adjacent(finished)grade next to building(HAG) 4.90 ®feet LI meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N.A ❑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 elevation
information./certify that the information on this Certificate represents my best efforts to interpret the data available.
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. Were latitude and longitude in Section A provided by a ( I_
® Check here if attachments. licensed land surveyor? ® Yes ❑ No
Certifier's Name SCOTT A.McLAUGHLIN License Number 5842 "'`= L
- •
Title VICE PRESIDENT Company Name McLAUGHLIN ENGINEERING COMPANY
Address 400 NE 3RD AVENUE City FORT LAUDERDALE State FL ZIP Code 33301
0,k?
Signature Date 10/17/14 Telephone 954.763.7611
MA Fs''Fn 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
L.LL V A I IVIV vLIX I II IVY1 I L , rJU C L
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COME ANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number:
4448 SW 27 AVENUE
City DANIA BEACH State FL ZIP Code 33312 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 Al.OWNERS NAME PER THE BROWARD COUNTY PROPERTY APPRAISERS WEBSITE. A5.GOOGLE EARTH
A9.a)NO ACCESS TO OBTAIN GARAGE SQUARE FOOTAGE
C2. REFERENCE BENCHMARK-BCED#1473,ELEVATION=8.977(NGVD1929)
C2.e)A/C PAD ELEVATION
Signature/....._ Date 10/17/14
__._ _
..- 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 . ❑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,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—G10.In Puerto Rico only,enter meters.
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—G10)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 Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: . ❑feet ❑meters Datum
G10.Community's design flood elevation: . ❑feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
®Check here if attachments.
FEMA Form 086-0-33(7/12) Replaces all previous editions.
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 166C-0008
Expires March 31, 2012
Federal Emergency Management Agency
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 RICHARD W AND MIMI ANN JENSEN(SURVEY NO 12-1325) Policy Number
A2. Building_Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
4448 SW 27 "AVENUE
City DANIA BEACH State FL ZIP Code 33312
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
LONG LEGAL 1
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude:Lat.26°4.006N Long.80° 10.594W 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 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 ® No
SECTION B-FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
rB1. 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 Elevation(s)(Zone
12011 C0306 F Date Effective/Revised Date Zone(s) AO,use base flood depth)
10/02/1997 08/18/1992 AE 7.00'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined 0 Other(Describe)
B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 0 Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date N/A ❑ CBRS ❑ OPA
SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: 0 Construction Drawings* ❑ Building Under Construction° 0 Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones A1-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 BCEBM NO 1476 Vertical Datum NGVD1929
Conversion/Comments N/A
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)7.07 0 feet ❑meters(Puerto Rico only)
b) Top of the next higher floor N/A. ®feet 0 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) 6.43 ®feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 6.52 ®feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 5.88 ®feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 6.08 ®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.❑
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? ® Yes 0 No •
`
i
Certifier's Name JOSE A PEREA License Number 4858
Title SURVE R AND MAPPER Company Name THOMAS J KELLY INC. 1 /
Address 812 ST T City PINECREST State FL ZIP Code 33156
Signature Date 10/1/2012 Telephone 786-242-7692 -
FEMA For 81 1, ar 09
See reverse side for continuation. Replaces all previous editions
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
4448 SW 27TH AVENUE
City DANIA BEACH State FL ZIP Code 33312 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.LOWEST ELEVATION OF MACHINERY OR EQUIPMENT=A/C SLAB
CONCRETE SLAB FOR ADDITION HAS AN ELEVATION OF 7.10'
BENCHMARK INFORMATION:SQUARE CUT AT SOUTHEAST CORNER OF CONCRETE WALK IN FRONT OF PAKS STORE,RESIDENCE 2131
GRIFFIN RO .SQUARE CUT IN 9'SOUTH OF SOUTHEAST CORNER OF BUILDING,250'WEST OF RAVENSWOOD ROAD.
ELEVATIO = .352'NGVD1929/REVISED FOR COMMUNITY NAME AND NUMBER 1/10/2013/C1. REVISED 1/16/2013
Signature Date 10/1/2012
® Check here if attachments
SECtI E-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 ❑feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is El feet El 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 higher floor
(elevation C2.b in the diagrams)of the building is 0 feet 0 meters ❑above or El below the HAG.
E3. Attached garage(top of slab)is 0 feet 0 meters El above or El below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters El 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 management
ordinance? ❑Yes 0 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
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. El 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: El New Construction El Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet 0 meters(PR)Datum
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
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
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
4448 SW 27TH AVENUE
City DANIA BEACH State FL ZIP Code 33312 Company NAIC Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix a,t 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.
12/02/2012
fp: i ; ,,,„:,
4 i .. .,
' '''r 11 R
„ ,
i.
, ,,
° ! ,1 I
a.
d Imo. ..`.J. .i -.-: - t ...-
cr
3- j2 - rt9
00,7,- , ,, ' liP/ , ,;„ . \
_ ,
y1 1:
IjIll !EW '' ram. .�..- i
f i: 11, t, !",4 li
€y x
1 it
F fp/jJ
are � '�- 'y
be
t
+ 1
.. t s .ice.
ir, a;, .'
S
- .. -
yea ' �_ '
.,� ' i�
� a
° " � +
c. '�. `;£ x _ a Mom;
;,
I ..
� `` ,, $
¢. �
dew dY� q ?;5 $' - ;i