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HomeMy WebLinkAbout34-2114-008-0220FOLIO#: 3021140080220 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Expires December 31, 2005 C.O.R.: 6.92 FT Important: Read the instructions on pages 1 - 0-0003067 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number CONFIRM BUILDING STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NO. Company NAIL Number 955 NW 159 DR CITY STATE ZIP CODE MIAMI FL 33134 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot Block of SUNSHINE STATE INDUSTRIAL PARK according to the plat thereof as recorded in Plat Book 78 at Page 58 of the public records of MIAMI-DADE County, Florida. BUILDING USE (e.g. Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) - ACCESSORY LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: I I GPS (Type): ( - - or I I NAD 1927 1 1 NAD 1983 1_1 USGS Quad Map I X I Other: NGVD 192 9 134. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD EL'EVAfflON(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use de ih of flood . p ing) 1202500080 J 07/17/1995 03/02/1994 AE 6FT B10.Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. I I FIS Profile I XI FIRM I I Community Determined I I Other (Describe): B11.Indicate the elevation datum used for the BFE in B9: I X I NGVD 1929 1 1 NAVD 1988 1 (Other (Describe): B12.Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? I_I Yes LX No Designation Date: SECTION C BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: I I Construction Drawings* I I Building Under Construction* I )f 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, 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 1929 Conversion/Comments N/A Elevation reference mark used 6 Does the elevation reference mark used appear on the FIRM? El Yes L-) No ❑ a) Top of bottom floor (including basement or enclosure) 8.68 ft. (M) #5204 43/30/2004 ❑ b) Top of next higher floor N/A ft.(m) FBI r ( N/A. c) structural membe _ N...,~,"zb nes only) a Bottdt of owest horizontal r V m) fE:( t'°` ~7~ {9dll, d) A(tachec~ garage (top of slab) N/A ft.(m)' fi i' 'I c: ill r,_i e Lowest elevatioh of machinery and/or equipment • I, 8I;°l-; C servicing the building (Des nbe m a,Comments area) N/A ft.'(mi w ❑ f) Lovst adjacent (finished) grade (LAG) 6.81 ft.(m) ~ hl 6. ft,(m) ❑ st adjacent (f9,E~ r h) No ~of eri'naft-At onehings (flo grade v e(HAns) within''II~II ~I II e a acent rade Lice umber `Emhossed Seal- od i I, i ven s ~ H~ II 9 N/A i , , Si '111 ❑ pl 1 1, li ~3 ~~~lill~,llu~ in N/A sq. In. (sq. cm) iiu 6° n r , a d Date i) Tota~ are of afl enn nent openI n (floo "`I" u ~ ~ I EE , OR ARCHITECT CERTIPICA`t io ION [~S~ 5I~VEOR~~ E,~r 'i Gtl it lij, 1 1 lllglllB~k .{^~~0l1~1~: ~I i1,ll i- I Ri:~: dl This certification is to be signed`and sealed ~anc survel & 6ng l certify that the informatio n in 1 lneer or architect authorized by law to certify elevation Info mation. II II nsI AI Ii,~.&I r 14.1 fhrsc11 ~I li "11111{ III ~e u e i ..erlullrfi Iljli~ III I tll I it TI I. 1 abl ^`'`e~a Sect~7 aii o , an , G~ 01 icate represents my best efforts to interpret the data avarll l understand that any tali e stal-Il e'Int inay be pihnishkable byiri ldr~iri7prisonment under 18 U.S. Code, Section 1001. 9 CERTIFIER'S NAME Ili H LICENSE NUMBER John Ibarra 5204 TITLE COMPANY NAME P rofe'ssional Land Surveyor NOVA SURVEYORS, INC. ADDRESS CITY STATE ZIP CODE 5582 N.W. 7TSTREET, SUITE 202 MIAMI FL 33126 SIGNATURE DATE TELEPHONE ill 03/30/2004 (305) 264-2660 81-1 31, SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces. copy the corresponding information from Section A. 0-0003067 For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NO. Policy Number 955 NW 159 DR CITY ' STATE ZIP CODE Company NAIL Number MIAMI FL 33134 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVcompany, and (3) building owner. COMMENTS NOTE: A/C ON ROOF OF BUILDING 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 E4. If the Elevation Certificate is intended for use as supportinq information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the buildinq 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 I ! I ft.(m) I I I in.(cm) I I above or I I 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 I I I ft.(m) I I I in.(cm) 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? 1 I Yes I I No I_ 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. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME CONFIRM ADDRESS CITY-- STATE ZIP CODE 955 NW 159 DR MIAMI - FL 33134 SIGNATURE DATE TELEPHONE COMMENTS -1 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. I 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.) G2. I I 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. I I The following information (Items G4-G9) is provided for community floodplain management purposes. G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OR COMPLIANCE/OCCUPANCY G4. PERMIT NUMBER mss: ISSUED G7. This permit has been issued for: I I New Construction I I 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 SIGNATURE TELEPHONE DATE COMMENTS I I Check here if attachments FEMA Form 81-31. JAN 2003 REPLACES ALL PREVIOUS EDITIONS