HomeMy WebLinkAbout34-2113-002-0095 dupe3D - a ► ► 3 - ~ 21- ocA Stf 4 ate - 0-44 a'4a
C. 0. R. 6.1 2
12-23-04
C 200q 1 I CQ,@-4}
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE 3
Important: Read the instructions on pages 1- 7.
SECTION A - PROPERTY OWNER INFORMATION
O.M.B. No. 3067-0077
Expires December 31, 200!
Krz'tst►r~c, a)~1~1-I 303
BUILDING OWNER'S NAME
ANGEL DEVELOPMENT ORDER NO.0412-101
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
21 NW 159 ST
For Insurance Company Ilse
Policy Number
Company NAIC Number
CITY STATE ZIP CODE
MIAMI FL 33169
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
PARCEL "A', BISCAYNE GARDENS SEC "C". SUB. PLATBOOK 40, PAGE 54
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 ##.###N#) ❑ NAD 1927 ❑ NAD 1983 0 USGS Quad Map ❑ Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFU' COMMUIWI Y NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE
UNINCORPORATED, AREAS 120635 MIAMI- DADE FL
B4. MAP AND PANEL
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUMBER
65. SUFFIX
86. FIRM INDEX DATE
EFFECTIVEIREVISED DATE
B8. FLOOD ZONE(S)
(Zone A0, use depth offloodir>g)
12025CO 80
1
7-17-95
3-2-94
AE
7.00
B10. Indcate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 139.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building localed in a Coastal Barrier Resources System (CEIRS) area or Othennise Protected Area (OPA)? ❑ Yes ®No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on. ❑ Construction Drawings'` ❑ Building Under Cornstruction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number I (Select fie 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 pfoogaph.)
C3. Elevations - Zones Al AM, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, ARIAE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3.-a4 below according to the building diagram specified in item C2. State the datum used. If the datum is different tan the datum used for the BFE in
Section B, covert 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 ConversaNComments
Elevation reference mark used 2102 W Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No
❑ a) Top of bottom floor (including basement or enclosure)
8. 41 ft(m)
ca
❑ b) Top of next higher floor
NIA. _ft (m)
❑ c) Bottom of West horizontal structural merrber (V zones only)
N/A. _ft(m)
o 0
❑ d) Attached garage (lop of slab)
7. 48 ft(m)
E 1
❑ e) Lowest elevation of machinery and/or equipment
w "
servicing the buikng (Describe in a Comments area)
8. 36 it(m)
E
❑ f) Lowest Aacent (finished) grade (LAG)
6. 7 to)
z' m
L3 J) Hirst a*cent (finished) gade (HAG)
Z. 9 AM
N
❑ h) No. of permanent openings (flood vents) within 1 fl. above adjacent Bade N
❑ ) Total area of al permanent openings (flood vents) in C3.h WA sq. in. (sq. cm)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information.
/ certify that the iriftnation in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIERS NAME WALTER E. VENEGA LICENSE NUMBER 3106
TITLE PROFESSIONAL LAND SURVEYOR COMPANY NAME CARIBBEAN LAND SURVEYOR'S
ADDRESS CITY STATE ZIP CODE
11865 SW 26TH STREET MIAMI FL 33175
SIGNATURE DATE TELEPHONE
12-23-04 (305) : 227-6967
Far tnsuraceCanparit.
IMPORTANT: In these spaces, copy the coffesponding information from Section A.
BUILDING STREET ADDRESS Orducling Apt., Unit, Suite, andfor Bldg. No.) OR P.O. ROUTE AND BOX NO. PatrdtrlVui ben
21 NW 159 ST
CITY STATE ZIP CODE `l,`timpaty NN Number
MIAMI FL 33054
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenthornpany, and (3) building awrw.
COMMENTS
❑ 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 (withaABFE), 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 bu ldrg for which this certificate is being completed - see pages 6 and 7. Ifnodagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the tailing is _ ft(m) _in.(am) ❑ abode or ❑ below (check one) the highest a went grade. (Use
nahaal grade, if available).
E3. For Building Diagra ns 6-8 with openings (seepage 7), the nett hider floor or elevated flow (elevation b) of the building is _ ft(m) _in.(=) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The by of the platform of machinery ardor equipment servicing the building is _ ft(m) _in.(am) ❑ above or ❑ below (dieck one) the highest a4acent grade. (Use
natural grade, if available).
E5. For Zone AO only: 9 no flood depth number is ava able, is the top of the bottom floor elevated in accordance with the corrmu niVs tloodplain management ordnance?
❑ 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 waters authorized repr ove who completes Sections A, B, C (Item C3.h arid C3.i only), and E for Zone A (without a FEMA-issued or communty-
issued BFE) or Zane AO must sign here, 7hestatements br Sec iiow A, Q C, &W E are correct to die best cftykrioWedge
PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑ Check here if attactrnents
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authored by law or ordnance to administer the carrrnunitt/s lloodplain 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 taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation infommation. (Indcate the source and date of the elevation data in the Garments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or co nmunity-issued BFE) or Zone A0.
G3. ❑ The blowing information (Items G4-G9) is provided for community Aoodplain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPUANCEIOCCUPANCY ISSUED
G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor (including basement) of the building is: - -ft(m) Datum:
G9. BFE or (n Zane AO) depth of flooding at the building site is: - - ft(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUMTY NAME TELEPHONE
SIGNATURE DATE
COMMENTS