HomeMy WebLinkAbout34-2116-001-0880FEDERAL EMERGENCY MANAGEMENT AGENCY
_ NATIONAL FLOOD INSURANCE PROGRAM
-cC ELEVATION CERTIFICATE
Lad0~ 9 7'/1'9 Importer Read the instructions on pains 1- 7.
40.2 3
SECTION A - PROPERTY OWNER INFORMATION For Insurance Caren use:
BUILDING OWNER'S NAME Policy Number
LEONARD AND REBECCA HOSS
BUILDING STREET ADDRESS (Indudung Apt, Unit Sine, andlor Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
15141 NW 3to AVENUE
CITY STATE ZIP CODE
OPA-LOCKA FL 330542518 -
PROPERTY DESCRIPTION (Lot and Bbdd Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 23, BLOCK 5 OF GUAVA GROVE ESTATES, PLAT BOOK 52, PAGE 45, MIAI"ADE COUNTY, FLORIDA
BUILDING USE (e.g., Residential, Nan-residerft Addillion, Accessory, etc. Use a Co rmw is area, if necessary.)
RESIDENTIAL
LATTTUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type):
( or ##AW#M°) ❑ NAD 1927 ❑ NAD 196:3 ❑ USGS Quad Map ® Other: NGVD
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
I ~ IAI~MCOMMUNITY ~ & COMMUNITY (AMBER I 82 COUNTY
FB3. STATE
LORIDA
134. MAP AND PANEL
B5. SUFFIX
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUMBER
B6. FIRM INDEX DATE
EFFECTIVE/REVISED DATE
138. FLOOD ZONE(S)
(Zone AO, use depth of flooding)
0090
1
07-17-1995
03.02-1994
"X"
WA
B10. Indicate the sauce of the Base Flood Elevation (BFE) data or base food depth entered in B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Oticer (Describe):
811. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1966 ❑ Other (Des ribe):
B12. Is the building located in a Coastal Banier Resanxs System (CBRS) area or Otherwise Protected Area (OPA)?❑ Yes ®No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Buildng elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' ® Finished Construction
'A new Elevation Certificate wA be required when construction of the buiktng is cornplets.
C2- Buikircg Diagram Number 1(Select the building diagram most similar to ft building fo W kh this certificate is being completed - see pages 6 and 7. If no diagram
accurately relo esents the bnikt V, Pauide a sketch or pholog aph-)
C3. Elevations - Zones Al-A30, AE, AM, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, ARIAH, AR/AO
Complete Items C3.-a-t below according to the buiding 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 measui menis 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 ConversioniComments
Elevation reference mark used Does the etevabon reference mark used appear on the RRW ❑ Yes ® No
o a) Tap of bottom floor (including basement or enclosure) 8. 15 ft(m)
o b) Top of next higher floor NIA. _ft(m)
o c) Bottom of lowest horizontal structural merrrber (V zones only) WA. _ft(m) c~ ' • "
o d)Abdvdgarage(topofslab) WA _ft(m)
o e) Lowest elevation of nrafty" ardor equip rnent W'm
servicing the bucking (Desrnbe in a Comnw is area) 7.15 ft(m) a ' L~ h ^ ° .
o t) Lowesta*cernt (finished) grade (LAG) 6.70 ft(m) m N , • t c , : ,
o g) Highest adjacent (finished) Bade (HAG) Z. 00 ft(m) 'A i
* u ~jr-:a
o h) No. of permanent openings (Rood vents) within 1 It above adjacent grade WA ! •
o ) Total area of all permanent openings (flood vents) in C3.h WA sq. in. (sq dm) : -
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
/understand that any false statement may be~:unishable by fine or imprisonment under 18 U. S. Code. Section 1001.
CERTIFIER'S NAME PILAR SOLER LICENSE NUMBER 6310
I
TITLE PROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME PSM & ASSOCIATES, PA LB # 7149
ADDRESS CITY STATE ZIP CODE
311 MN 136TH AVENUE MIAMI FL 33182-1952
SIGNATURE DATE TELEPHONE
11-05.02 (305) 2264337
O.M.B. No. 3067-0077
Expires July 31, 2002
IMPORTANT: In these spaces, copy the com mponding inknnadon from Sec>bon A Far kwanoe
BUILDING STREET ADDRESS (inducing Apt., Unit, Suite, andlor Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number
15141 NW 32ND AVENUE
CITY STATE ZIP CODE Company NAIL Number
OPA-LOW FL 330542518
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Ce 9cal~e for (1) =nninly official, P) inswance agentlcartparry, and (3) building mvier.
COMMENTS
CROWN ELEVATION: 6.75
BENCH MARK USED: MIAMI-DADE COUNTY BM # NA45, LOCATOR # 2132 W, ELEVATION 8.36 AIR CONDITIONER i CONCRETE SLAB ELEVATION 7.15
❑ Check here Naftadynents
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A NIATHOUT a1
For Zone AO and Zone A (without BFE), cornplete Items E1 through E4. If the Elevation Certficale is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1.Buk"DiagarnPkmber_(Sdectthebulftdragarnmostsi d tothebuikirgforwhichthiscertiiicateisbeing completed-seepages6and7.Ifntodiagamaaxratey
represents the bukliing, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or endostm) of the building is_ tt(m) _kn.(crn) ❑ above or ❑ below (click one) the highest ad)acent Wade. (Use
natural grade, if avallable).
E3. For Building Diagrams 6.8 with openings (seepage 7), the next higher floe or elevated floor (elevation b) of the building is _ ft(m) _in.(crm) above the highest adjacent
grade. Complete items C3.h and C3.i on bout of fem.
E4. For Zone AO any: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the cornnnruy's tloodpta n management ordivance?
❑ Yes ❑ No ❑ Unknown. The local offlaal must cei* this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's autha cmd representative who canpletes 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 REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑ Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is adthoriaedby law or ordmartce to admnster the a rrnnn nVs floodplain management ordnance can complete.Secfions A, B, C (orE), and G of this Efevahon _
Certificate. Complete the applicable item(s) and sign below.
G 1. ❑ The information in Section C was taken from otter 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 information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A connnrxmily official completed Section E far a building kxated m Zane A (without a FEMA4ssued or canmurily-issued BFE) or Zane A0.
G3. ❑ The follaimV dmation (Items G4-0) is provided for community floodp w management purposes.
G4. PER%IT NUMBER G5. DATE PERMIT ISSUED M. DATE CERTIFICATE OF COMPLIANCIDOCCUPANCY ISSUED
G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G8. Elevation of asst lowest floor (induJng basement) of the building is: _ -ft(M) Datum:
G9. BFE or (m Zone AO) depth of flooding at the building site is: - _ ft(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
Check here if attachments