HomeMy WebLinkAbout34-2113-033-0030Zoo 42229.3 FEDERAL EMERGENCY MANAGEMENT AGENCY
PROCESS#
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
FOLIO# 30-2113-033-0030 ELEVATION CERTIFICATE Expires December 31, 2005
C.O.R. 5.2'
Important: Read the instructions on pages 1.7.
SECTION A- PROPERTY OWNER INFORMATION ) FalnsuranceCormpanyUse: )
15790 NE 2-AVENUE
Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
CITY STATE ZIP CODE
MIAMI FL 33162
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 3 BLOCK 1 OF "MARCELLUS SUBDIVISION" PB 160 PG 44 OF DADE COUNTY RECORDS
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, ff necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type):
( #rP - -##.##F' or ##.rar###) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAIME& COMMUNITY NUMBER
B2.000NTY NAM=
B3. STATE
UNINCORPORATED-120635
MIAMI-0ADE
FLORIDA
B4. MAP AND PANEL
B5. SUFFIX
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUMBER
B6. FIRM INDEX DATE
EFFECTIVEREVISED DATE
BB. FLOOD ZONE(S)
(Zone AO,usedephoffiocdkg)
1202500083
J
7/17M
3294
AE
1.00
810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ AS Profile E FIRM ❑ Community Delemrlned ❑ Oltier (Describe):
B11. Indicate the elevation datum used for the BFE in B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a Coastal Bader Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date
SECTION C - BUILDING
C1. Building elevations are based on: ❑ Constmctim Drawings* ❑ Building Under Construction* E Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1(Seled 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, ARIA, APJAE, ARIAI-A30, ARIAH, AR/AD
Compete Items C3.-ad 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 1929 Conversion/Comments NONE
Elevation reference mark used N-747 Does the elevation reference mark used appear on the FIRM? ❑ Yes E No
o a) Top of bottom floor (inducing basement or enclosure)
B.Oft.(m)
d
o b) Top of ned higher floor
WA. -ft (m)
o c) Bottom of lowest horizontal st uctural member (V zones only)
NA--ft(m)
$ o
o d) Aftadred garage (top of slab)
6.8 ft.(m)
E
o e) Lowest elevation of machinery and/or equipment
- ,
servicing the building (Describe in a Comments area)
1.4 ft.(m)
E 16
o f) Lowest adjacent (finished) grade (LAG)
62 ft.(m)
2 N
o g) Highest adjacent (finished) grade (HAG)
6A ft.(m)
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade WA
8
9o(-Yo i) Total area of all permanent openings (flood vents) in C3.h WA sq. in. (sq. on)
SECTION D- SURVEYOR, ENGINEER, ORARCHITECT CERTIFICATION
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.
I understand that any false statement may be punishable by fine or imprisonment under 16 U.S. Code Section 1001
CERTIFIERS NAME : PABLO J. ALFONSO LICENSE NUMBER : #5880
NAME
ADDRESS T ) CITY STATE ZJP CODE
6175 NW 153 STREET, SUITE 103 MIAMI FL 33014
9M/06 T: 305-822-6062 F: 305-827-9669
FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
IMPORTANT: In these spaces, copv the corresponding information from Section A. i For lnsuranoeCompanyUse: i
15790 NE 2 "AVENUE
Poky Number
CITY STATE ZIP CODE I Canpany NAIGNumber
MIAMI R. 33162
SECTION D • SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community offidal, (2) insurance agent/oormpany, and (3) building owner.
LOWEST ELEVATION OF MACHINERY AND/OR EQUIPMENT SERVICING THE BUILDING REFERS TO THE A/C (7.4)
Check
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 -seepages 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.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, 9 available).
E3. For Building Diagrams 68 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ fl.(m) _in.(am) above the highest adjacent
grade. Complete Hems C3.h and C3.i on front of form.
E4. For 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 ordnance?
❑ Yes ❑ No ❑ Unknown. The"offidal must oertiry this information in Section G.
SECTION F • PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owners authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMAissued or community-
issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE
Check
SECTION G • COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordnance 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.
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
slate or local law to certify elevation infomrabon. (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 FEMAAssued or communityissued BFE) or Zone A0.
G3. ❑ The following information (items G4-G9) is provided for community floodplain management purposes.
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 (in Zone AO) depth of flooding at the building site is: _ -t.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE
❑ Check here if attachments
FEMA Form 81-31, JUL 00 REPLACES ALL PREVIOUS