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Home My WebLink About34-2115-005-11203 ® 5- d zi, FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM ®t Expires July 31, 2002 PROCESS # ELEVATION CERTIFICATE C . O . R . = 8.5 N . G . V . D Important: Read the instructions on pag es 1- 7. C- 9® (0 &~'7 SECTION A - PROPERTY OWNER INFORMATION For Ira rarice Company Use: BUILDING OWNER'S NAME Policy Number EPISCOPAL CHURCH OF THE TRANSFIGURATION BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number >IK2AONW 19 AVE CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 21, 22, 23, 24 & BLK 1 FIRST ADDITION MAGNOLIA SUBDMSION PB 44 PG 18 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) NON-RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - or ❑ NAD 1927 ❑ NAD) 983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME B3. STATE CITY OF OPA-LOCKA 120657 MIAMI-DADE FL B4. MAP AND PANEL B5. SUFFIX B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B6. FIRM INDEX DATE EFFECTNSREVISED DATE B8. FLOOD ZONE(S) (Zane AO, use depth of flooding) 1202500090 J 7-1795 3-2=94 AE 7.00 B10. Indicate the source of the tease mood tievavon t6t-t) data or oase nova aepm enierea in ray. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 69: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® 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, AR/AE, 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 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 Conversion/Comments Elevation reference mark used CBM Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (including basement or enclosure) 9. 2 ft.(m) cc o b) Top of next higher floor NIA. o c) Bottom of lowest horizontal structural member (V zones only) N/A. o 0 o d) Attached garage (top of slab) N/A_. ft.(m) E 011 LIJ (0 me ~ u m n a r achi ip nt ery and/or eq o e) Lowest elevation of ' L,w e 9.2 ft. (m) servicing the budding (De cribe in a Comments area A/c - - w , ~ 9.0 ft.(m) ' o f) Lowest adjacent (finished) 9fade (LAG) zi°' n t 9 2 ft.(m) o g) Highest adjacent (finished) grade (NAG) ~ 1~` q'2~`.y, _ - I Q~ o h) No. of permanent openings (flood vents) within 1 ft: above adjaceli, e wA u I!JiI i s ar,a~it o i Total area of all permanent openings flood vents) in C3.h N/A sq. in. (sq. txn) 9( i ' I SECTION 6-lSURVE` y This certification is to be signed 'and sealed 6y a land Isurveyor,'E :il;sII I I certify that the information in Sections A, B, and C on this certif 1 understand that any false statement may be punishable by fine CERTIFIERS NAME JOSE L SANFIEL TITLEVICE PRESIDENT t OR ARCHITECT CERTIFICATION j, I ecf" authorized by law to certify elevation infom ~y~test efforts to interpret the data available. aim . urr er 18 U. S. Code, Section 1001. ~i LICENSE NUMBER PLS. COMPANY NAME GLOBAL DIMENSIONS INC. El .I I. - ition. ! iII 5636 ADDRESS CITY STATE ZIP CODE 7535 W 24 AVE. HIALEAH FL 33016 SIGNATURE DATE TELEPHONE 6-24-02 305-512-4225 IMPORTANT: In these spaces, copy the corresponding information from Section A. For In%== company Use. BUILDING STREET ADDRESS (Inc uft Apt, Unit, Sure, and/or ft. No.) OR P.O. ROUTE AND BOX NO. Policy Number CITY STATE ZIP CODE Company NAIL Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agerNoompany, and (3) building owner. COMMENTS CENTERLINE FOR NW 19 AVE = 8.5 N.G.V.D. ❑ 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.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6$ with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft(m) _in.(cxm) above the highest adjacent grade. Complete items 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 ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must oertify 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, C (Items 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 correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES 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. G1. ❑ The information in Section C was taken from other documentation that has been sided and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local !aw 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 A0. G3. ❑ The fdk7wN information (Items G4-G9) is provided for community floodp!ain 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 is: _ft.(m) Datum: G9. BFE or (n Zone AO) depth of flooding at the building site is: _ ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachments