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HomeMy WebLinkAbout34-2117-004-0320FEDERAL EMERGENCY MANAGEMENT AGENCY 'r+lees~ - NATIONAL FLOOD INSURANCE PROGRAM Fo o No. 30-2117-004-0320 CROA = {y~i}J!~~ NMIY/ ELEVATION CERTIFICATE 11~~(~Y Y. ■ Li Yy (/.~~.~i~(` l~Y . O.M.B. No. 3067-0077 Expires July 31, 2002 Im ortant: Read the instructions on es 9 - 7. e ° 700 `2 /g-::;7 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number REBUILDING OUR COMMUNITY, INC. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAiC Number 15940 NW. 41 AVENUE CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A PORTION OF TRACT 4, "REVISED PLAT OF VENETIAN GARDENS", PB. 31-37, MIAMI-DADE COUNTY RECORDS. BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - or ❑ NAIL 1927 ❑ NAD 1983 ❑ USGS Quad Map 0 Other: Automatic Level N/A SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE 120635 (UNINCORPORATED AREAS) Miami-Dade Fl. B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 12025CO080 J 7-17-95 3-2-94 "X" N/A u. inulcate Lne source oT the vase a-mou t=ievavon (tsi-C) data or base now (deptn enterecl in B8. ❑ FiS Profile 0 FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used far the BFE in 139: ® 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 M 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, V1430, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-i 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 N. G. V. D. Conversion/Comments N/A Elevation reference mark used 7.52' Does the elevation reference mark used appear on the FIRM? ❑ Yes [R No ❑ a) Top of bottom floor (including basement or enclosure) 8.77 ft(m) aa~ No. LS 5938 ❑ b) Top of next higher floor N/A , ft(m) ❑ c) Bottom of lowest horizontal structural member (V zones drily) N/A . ~fit.(m) ❑ d) Attached garage (top of slab) N/A. fL(m) a = T r ~j_ ❑ e) Lowest elevation of machinery and/or equipment E ~gnature: servicing the building 8. 50 ft.(m) _ k ❑ f) Lowest adjacent grade (LAG) 7.6 ft.(m) m ❑ g) Highest adjacent grade (HAG) 7. 8 ft. (m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A ❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER OR ARCHITECT CERTIFICATION ,wee ~l if ifl W This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law toy' " f,110 i certify that the information in Sections A, B, and C on this certificate represents my best efforts to interprd 'l l understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Sec #r CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER 5938 TITLE: PROFESSIONAL 1EYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CO ii. SULTAN' SIGNATURE J FFMA Pill R1-S1 Al Jr, gg DATE 8FF RFVFRSF Rill FOR C ONTiNI IATION STATE ZI lab/e. Nil III a~ ~i u i INC. ODE RFPI Arif§ Al I i-4t=Vie t m F["?I omr; IMPORTANT: In these spaces, copy the corresponding information from Section A. Poo. Insurance Company Use BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number. 15940 NK 41 AVENUE CITY STATE ZIP CODE Cempany NAtC 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 agentlcompany, and (3) building owner. 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 (without BFE), complete Items E1 through E4. ,f the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C roust 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. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is ft(m) _in.(cm) above the highest adjacent grade. 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 certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representat;ve who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO roust sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S iiIAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is auth;- ed by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, 13;y I✓ (or E), and G :jf thqs Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information i' Secl un C,vas taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or'b rchitect w o is ti-lAhorized by state or local law to certify elevation information. (Indicate the source and date of the elevation da#a to the Cor111er±s area below.) r ~ Lw G2. ❑ A community o*^ial com l tee`Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or y F ;ilw Zone .~~0. G3. ❑ The following infoitna€io'n (Items 0 9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED SS EDTE CERTIFICATE OF COMPLIANCE/OCCUPANCY s'aeon i'st16 d for ❑ New Construction ❑ Substantial Improvement G7. Th ' 11 ~ s ermrf h~ ~ floor (including basement) of the building is: -ft. (m) Datum: G8. Elevation of as-built lowest G9. BFE or (in Zone AO) dep h'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 FFMA Form 81-11 At Jr-, PP RFPI AC PS At I PRFVIC?t IS FnITIONS