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Home My WebLink About4781 SW 39 Ave U.S.DEPARTMENT OF HOMELAND S-. URITY OMB No. 1660 0008 Federal Emergency Management Agency National Flood Insurance Program Expiration Date:November 30,2018 ELEVATION CERTIFICATE Important:Follow the instructions on pages 1-9. Copy an pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner, SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Budding Owner's Name Policy Number: AQUA ISLES A2. Bui ding Street Address(including Apt.,Lam.,,Stale,andlor Bldg.No.)or P.O.Route and Box No. Company NAIL Number: 4781 SW 39TH AVENUE State ZIP Code DANIA BEACH Florida 33312 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Descr*tion,etc.) FITNESS CENTER IN PARCEL A a Portion of Aqua Isles Plat Broward County,OUR JOB#: 16-02-033 A4. Builtfing Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) NON-RESIDENTIAL A5. LatiNude&Longilude: Lat.26°03'48.74"N Long.80°11'5567"W Horizontal Datum: ❑NAD 1927 Qx NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT. Balding Diagram Number 1 B All. For a building with a crawispace or andosure(s): a) Square footage of crawlspace or ems) n/a sq ft b) Number of permanent flood openings in the crawlspace or endosura(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in AB.b 0 sq in d) Engineered flood openings? El yes No A9.For a building with an attached garage: • a) Square footage of attached garage n/a sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in Att.b 0 sq in d) Engineered flood openkigs? Q yes N] No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NFIP Community Name h Community Number 82.County Name 83. State CITY OF HOLLYWOOD, 125113 84.MapiPanel B5.Suffix 86. FIRM Index 87.FIRM Panel 88.Flood Zone(s) 89.Base Flood Elevation(s) Number Date Effective/ Zone AO,use Base Revised DateFlood Depth) 12011C0554 H 08/18/2014 08/14/2014 X N/A ' 810. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in item 89: FIS Profile El FIRM []Community Determined []Other/Source: 811. Indicate elevation datum used for BFE in Item 89: N] NGVD 1929 Qx NAVD 1988 Other/Source: 812. Is the building located in a Coastal Banter Resources System(CBRS)area or Otherwise Protected Area(OPA)? Yes No Designation Date: CBRS 0 OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 11 of 6 B ELEVATION CERTIFICATE Expiration No. Dale: 00 Expiration Date 1November 30,2018 IMPORTANT:in these spaces.,copy the corresponding ii annation from Section A. FOR INSURANCE COMPANY USE Building Street Address(inducting Apt•,Unit,Suite,andtor Bldg.No.)or P.O.Route and Box No. Pori y I 4761 SW 39TH AVENUE City State ZIP Code Company NAIC Number DANIA BEACH Florida 33312 SECTION C BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: 0 Consbudion Drawings* El Building Under Construction* Frisked Constuchon *A new Elevation Caracole will be required when won of the building is complete. C2. Elevations-Zones A11-A30,AE,AH,A(with BFE),VE,V1 V30,V(with BFE),AR,AR/A,ARIAE AR/A1-A30,AR/AH,AR/AG. Complete terns C2a-h below according to the building diagram specified in Item Al.In Puerto Rico only,enter meters. Benchmark Utlzed: SEE COMMENTS Vertical Datum:NAVD 1988 Indicate elevation datum used for the elevations in kerns a)through h)below. NGVD 1929 NAVD 1988 []Other/Some: 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,crawispaoe,or enclosure floor) 7. 0 JJ feet [] meters b) Top of the next higher floor N/A. El feet [] meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A. { feet 0 meters d) Attached garage(top of ) N/A. l feet fl meters e) Leanest ele+ratiorr of machinery or equiprnarrt ServiCing the building 6 56 feet [] meters (Descrthe type of equipment and location m Ccnrrnenis) f) Lowest adjacent( red)trade next to b ng(IAG) 6. 20 D fleet meters g) Highest adjacent(trashed)grade next to building(HAG) 6.82 Q feet 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. feet 0 meters at uctura support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a lid surveyor,engineer,or architect authorized by law to codify elevation information_ certdy that the information on this Certificate represents my best efforts to interpret the data wadable.1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? El Yes D No ❑Check here if attachments. Certifier's Name License Number LUIS J.ORTIZ 7006 • �54n eORT�'� Title PSM N f :•C+ � Company Name . , 4 ,. No.t ,n: BASELINE ENGINEERING&LAND SURVEYING - Address STATE e 1400 NW 1ST COURT � '•, FL .•'4 City State ZIP Code ma`s " ys BOCA RATON Florida 33432 �`++ r i e 3 a °*N Signature Date Telephone LUIS J ORTIZ LS 70 :-der: ;r_ --- - •• 12/06/2016 (561)417-0700 Copy all pages of this Elevation and at attachments for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(including type ofequipment and location,per C2(e),if applicable) A 5)GOOGLE EARTH C2(E)A/C PAD(located at NE corner of bldg.) BENCHMARK REFERENCE: BROWARD COUNTY BENCHMARK#1479, ELEVATION =6.961'NGVD 1929(5.363'NAVD 1988, converted using Vertcon Software-cony factor 1.598') FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 660-0006 ELEVATION CERTIFICATE Elea No. November 30,2018 IMPORTANT:to these spaces.copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address(ncWdng Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: 4781 SW 39TH AVENUE City State ZIP Code Company NAIC Number DANIA BEACH Florida 33312 SECTION E-BUILDING ELEVATION INFORMATION(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,Brand C.For Items El-E4, use natural grade,it available.Check the measurement used.In Puerto Rico only; enter meters. Et. Provide elevation information for the following and check the appropriate lxoxes 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, araurtspace,or encloscure)is N/A. fl feet ❑meters ❑above or ❑below the HAG. h) Top at both floor(including basement, crawlepace,or enclosure)is N/A ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 anchor 9(see pages 1-2 of instructions.), the next higher floor(elevation C2.b in the )of the building is N/A ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is N/A ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of macihihery andior equipment servicing the building is N// `feet ❑meters ❑above or ❑below the HAG. ES. Zone AC)only:If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's Ioodplaurh management ordinance? ❑ Yes ❑ No Li Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The owner or owners authorized representative who completes Sections A,8,and E for Zone A(without a FEMA-issued or community 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 or Owners Authorized Representative's Name Address City State ZIP Code Signature Dale Telephone Comments ❑Check here if attachments. FEMA Form 086-0-33(7/15) Replaces alt previous editions. Form Page 3 of 4 • • OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date:November 30„2018 IMPORTANT::hi these spaces,copy the cormponceng information from Section A. FOR INSURANCE COMPANY USE BiSiding Stet Address Cog Apt.,Unit,SuiTe,andier Bldg.No.)or P.O.Route and Box No. Policy Number: 4781 SW 39TH AVENUE City Stake ZIP Code Company NAIC Number DANIA BEACH Florida 33312 SECTION G COINIUMTY INFORMATION(OPTIONAL) The local official who is authorized by law or orrhuanne to administer the coax 's floodplain management ordinance can complete Sections A,B.C(or E),,and G of this Elevation Cam.Complete the applicable item(s)and sign below.Check the measurement used in Items G8-610.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 stsvewr, engineer,,or a d ct 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 fix a budding located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. [I The following information(items G4-G10)is provided for community fioodplam management purposes. G4. Perrot Number G5. Gate Permit Issued G6. Date Certificate of Compliance/Occupancy Issued 9 -~ 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: El feet Q meters Datum — G 10. Community's design flood elevation: fl feet ❑ meters Datum _ Local Official's Name Title Community Name Telephone Signature Date Comments(including type of equipment and location,per C2(e),if applicable) Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6