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HomeMy WebLinkAbout34-2117-004-2480t Process No.C•A Z ~2fi 0 5154y NFEDERAL EMERGENCY ATIONAL FLOOD INSURANCE PROGRAM Folio No. 30-2117-004-2480 O.M.B. No. 3067-0077 Crown of Road= 9.3 Feet N.G.V.D. ELEVATION CERTIFICATE Expires: December 31, 2005 Important: Read the instructions on pages 9 - 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 15640 NW. 38 COURT CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A PORTION OF TRACT 57 OF "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 ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: N_A 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) 1202500090 J 7-17-95 3-2-94 "X" N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile 1Z FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® 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: N/A 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, AR/A, 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 NGVD 29. Conversion/Comments N/A Elevation reference mark used 7.52' Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No t ❑ a To of bottom floor includin basement or enclosure 10. 30 ft. m P ( 9 ) - ( ) Lic, iS0 No. LS 5938. ❑ b) Top of next higher floor N/A. _ft.(m) Gate - ~ , ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. ~ft.(m) o o- f04=03 ❑ d) Attached garage (top of slab) N/A. fit. rn L k Y W cc ❑ e) Lowest elevation of machinery and/or equipment Slgrafde: servicing the building (Describe in Comments Area) 2_. 82 ft.(m)r ❑ f) Lowest adjacent grade (LAG) g . 2 ft.(m) ~ CO ❑ g) Highest adjacent grade (HAG) 9. aft(m) ❑ h No. of permanent openings flood vents within 1 fit. 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 CERTIFICATIC; N l'I 'I ~ ' I' II'N H 'I !I R This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpn 1 understand that any false statement may be punishable by fine or imprisonment under 98 U. S. Code, Se CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER: 5! TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CON ADDRESS CITY STATE 7830 NW, 174h T RACE MIAMI Fl. SIGNATURE DATE TELEPHONE 10-07-03 (305)362-2 FFMA Fnrm R'I .ion 51111.4 OFF RFVFR.qF RIJIF FnP C:()NTINI IATI()N RFr_ I elevation information. ll data available. IMPORTANT: In these spaces, copy the corresponding information from Section A. ror Insurance;Cornpany Use BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O_ ROUTE AND BOX NO. Policy Number 15640 NW. 38 COURT CITY STATE ZIP CODE Company NAIC 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 agent/company, 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. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMB-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. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is T ft.(m) _ in.(cm) above the highest adjacent grade. E4. The top of the platform of machinery and/or equipment servicing the building is _ft.(m)_in.(cm) ❑ above or ❑ 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? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERT Y OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. 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 authorizedly 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. Co "nplete the applicable item(s) and sign below. 31. ❑ The information in Section d^tastaken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized state ar loc taf to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) al G2. 01 A cA_rnundy official corfipleted Ste. tion E for a building located in Zone A (without a FEMAassued or cornmunity4ssued BFE) or Zone AO. G3. ❑ The fot'owtrig infol-rna66n (Ife ~s G4-G9) is provided for community floodplain management purposes. ' "`a4} G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY G4. PERMIT NUMBER ISSUED ,r'w of . G7. This permit hG~3 ibpen Isst?ed for' j❑ New Construction ❑ Substantial Improvement G8. Elev016nP of a, bi iltylowest hoor'('including basement) of the building is: ft-(M) Datum: G9. BFEor (I'n Zone AO) depthof 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 F~nrm AI_R1 lanjinrv 900.1 PPPI A( F.q Ali PRFVir)i m FnITIONC