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HomeMy WebLinkAbout34-1136-011-1200, dupePROC# C 970444783 FEDERAL EMERGENCY MANAGEMENT AGENCY :FOLIO # 3011360111200 NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 PER CLIENT FROM BUILDING PERMIT Expires December 31, 2005 ELEVATION CERTIFICATE Important: Read the instructions on paces 1 - 7. a. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number Morais Lloyd Witter BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIL Number Illh 20685 NE 2nd Avenue CITY STATE ZIP CODE Miami Florida PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) L. 1 B1. 37 "Third Add. to Andpve.r" 84/88 Dade. BUII~DINC~ ~JSE (e.g. Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) esi ential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1-1 GPS (Type): ( or I-I NAD 1927 1_1 NAD 1983 1_1 USGS Quad Map 1_1 Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE Unincorporated Dade. 120635 Dade.' I Florida 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) 120250 0081 J 7/17/95 3/2/94 !XI - B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. I-I FIS Profile A FIRM 1_1 Community Determined 1_1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: 1X I NGVD 1929 1_1 NAVD 1988 1`1 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_J Yes 1i1 No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: I_lConstruction Drawings* 1_1Building Under Construction* IX_lFinished 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, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a-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 NGVD 29 Conversion/Comments Elevation reference mark used Dade County B'o`x Does the elevation reference mark used appear on the FIRM? Yes No ❑ a) Top of bottom floor (including basement or enclosure) 8 . 0 ft. (m) ❑ b) Top of next higher floor N/A. ft.(m) In 2/9/04 ❑ c) Bottom of lowest horizontal structural member (V zories only „r ;,N/A ft (m) 46 alN 'I ` It s l!:.00 Attached garage (top of slUabi) ! 111 I ~.N 1, I ''II I ~ uil I ' II €I Il , ~ ! ~ ~ I El dJ IAN/A t.(m) ;I ISIi. I • 1I~,In: -1 t ell 1 I ra 1 i11 1!I ':11 I'I 1 !.I 4111 i ' 1d/or'eqi 0"b I i311 UJ (0 a Loirest elevation of machine 6 6 y i h b d F, 1 a I- ~ U11ti` ' I ll I a.,al I u ~H~III, 1 1 I. I 1!! 1 i1 O 1.M.y„ m1 servicing the builds \ ~ng (Decrib e ha iComments area.)' 7 2 ft-(M) Q y 7 0 ft.(m) ade (LAG) z ❑ f) Lowest adjacent (finished) gra ❑ g) Highest adjacent (finished) grade (lA) 7 2 ft.(m) ❑ h) No. of permanent openings( ooild ver 16) within I ft. above adjaceni grade L. S . NO. 32 77 ❑ i) Total area of all permanent o'ISenindl i 1~~Elood vents)'in C3.h 1 sq. in. (sq. cm) Std'h6IN D` ' `tURVEYOk, ENGINEER, OR ARCHITECT! CERTIFICATION IP Ilil ni k II III I'.. I~nil lP ih' This certification is to be signed and'le6a~ed by h land surveytir, engineer, or architect authorized by law to certify 'elevation information. r II I1110 0 I' I II ~1 Ir : 1, I certify that the information in Secfidns A, r d C on fhis certificate represents my "best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonfnent under 18 U. S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER ROBERT T. BOGLE L.S. No. 3277 TITLE COMPANY NAME ADDRESS CITY STATE ZIP CODE 7080 TAFT STREET HOLLYWOOD FLORIDA 33024 SIGNATURE DATE TELEPHONE f 2/9/04 T (954) 961-8008 FEMA Form 81-31, January 2003 See reverse side for continuation. Replace§ ail previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 20685 NE 2nd Avenue CITY STATE ZIP CODE Company NAIC Number Miami Florida SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS _4; 1_1 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 E5. 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, Ift. (m) in (cm) above or 1_1 below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1_1-1 ft. (m) 1-1_1in. (cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is 1_1-1 ft. (m) 1-1-1 in. (cm) 1-1 above or 1-1 below (check one) the highest adjacent grade. (Use natural grade, if available.) E5. 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? 1_1 Yes 1 _1 No 1 I 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 representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA-issued 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. ~I PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME u ii ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE I' COMMENTS I I 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. 1-1 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 information. (Indicate the source and date of the elevation data in the Comments area below.) V G2. 1_1 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO G3. 1-1 The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMITrNUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for: 1-1 New Construction 1-1 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: ft. (m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME - TELEPHONE SIGNATURE DATE COMMENTS " 1_1 Check here if attachments i FEMA Form 81-31, January 2003 Replaces all previous editions