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Home My WebLink About34-2109-015-2320 accessory bldgFLULKAL tMLKULN(;Y MANAUtMLN I AGLN(:Y O.M.B. No. 3067-0077 I ? p p NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200 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 Eduardo Perez & Tomasa BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 3467 NW 179th Street (Accessory building/ storage) CITY STATE ZIP CODE Miami FL 33142 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 16, Block 9, PB 70-62 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 ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE Unincorporated Miami-Dade County 120635 Miami-Dade County FL B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEIREVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of flooding) 12025C 0080 J 7/17195 03/02/94 AE 7.09 1310. Indicate the source of the Base rlooa elevation tart aata or ease nooa ae to enterea in md. ❑ FIS Profile ®FIRM [I Community Determined x ❑ Other (Describe): ~r B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) . B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Prot ecjed AreaOPA)? Yes ~ No, Designation Date SECTIONC - BUILDING ELEVATION; IN ORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Gonstruction* ® 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 See 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, ARIAE, ARIA1 A30, ARIAH, ARIAO Complete Items C3. a4 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._Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD Conversion/Comments Elevation reference mark used N727 Does the elevation reference marls used appear on the FIRM? ❑ Yes ®No o a) Top of bottom floor (including basement or enclosure) 10. 00 ft.(m) x ; a o b) Top of next higher floor N/A. _ft.(m) r o c) Bottom of lowest horizontal structural member (V zones only) N/A. _ft .(m) 00 o d) Attached garage (top of slab) N/A. o e) Lowest elevation of machinery and/or equipment w ji ~M1 I•fi ~ -Yip h e, servicing the budding (Describe in a Comments area) 10.00 ft.(m) E -C0 o f) Lowest adjacent (finished) grade (LAG) 8.60 ft.(m) y u' ' o g) Highest adjacent (finished) grade (HAG)=., . 9. 00 ft m)" o h No. of permanent openings (flood vents wthiri1 ft above adJacent 9rade-None / 121/0 I" M86' ; r ) N" t o i Total area of all permanent openings flood vents in C3.h N/A sq. in. (s . cm - ( ) q ) 11 ml ~~.l~ a i ~ I K ~ elfl I i SECTION D -SURVEYOR; ENGINEER, 012 AR~HITECT CER FICATION ~ This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.' I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 j I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME Jose F. Lopez LICENSE NUMBER #3086 TITLE LAND SURVEYOR & MAPPER COMPANY NAME J. F. LOPEZ & ASSOCIATES, INC. CITY STATE ADDRESS ZIP CODE 7900 NW 155th Street, Suite 104 Miami Lakes, FL 33016 SIGNATURE DATE TELEPHONE , id /12(Q4 305 828-2725 fall p FEMA Form 81-31, January 2003 See reverse side for continuation. 7-Replaces` ieviou§ editions III ii,I IMPORTANT: In these spaces, copy the corresponding infonnadon from Seddon A F=orkw anoeca ,►We: BUILDING STREET ADDRESS (IncudirxJ Apt, Unfi, Suite, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO. Poky Number 3467 NW 179th Street C Accessory storage room CITY ' STATE ZIP CODE Company NAIL Number Miami FL 33142 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 HIGHEST CROWN OF ROAD ELEVATION IN FRONT OF PROPERTY: 8.10 FEET, NGVD - ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(crn) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is - ft.(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natum! grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated-in acwrdance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION"P - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, C (gems C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are cored 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 i ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The locaf.9ffua? i i io is authorized by (aw or ordinance to administer the communiity's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Cer'u'j'iGa~e. Cor=nplet(~e ai3 'cable item(s) and sign below. G1. ❑ The information in Section C Was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local aw tircertify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) ~on E for a building located in Zone A (without a FEMA4ssued or community-issued BFE) or Zone A0. . G2. ❑ Atom un~ official oompleted Secti9 is provided for community floodplain man ` t purposes. G3. nrmatlon'Items G4-G _ G4. PERMIT NUM86k-G6. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED A s 17 I-. G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built 1 lowest floor (inducting basement) of the building is: _ft.(m) Datum: (i cep flooring at the building site is: ft.(m) Datum: G9. BFE or n Zone AO) depth of CIAL'S -NAME - TITLE LOCAL OFFI