HomeMy Public PortalAboutSanctuary Pl_17OMB No. 1660 -0008
Expiration Date. July 31, 2015
U.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
Vamma/ rl,,,xl MAW , „t« t'/Ub4con Important: Read the instructions on pages 1 -9.
ELEVATION CERTIFICATE
SECTION A - PROPERTY INFORMATION
Al. Building Owner's Name Betsy & John Rabun
FOR INSURANCE COMPANY USE
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O Route and Box No.
17 Sanctuary Place
Company NAIC Number:
City Tybee Island State GA
ZIP Code 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 8 -1 Bay Ward Tybee Island, Tax Parcel #4.0022 -01 041
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.)
A5. Latitude /Longitude: Lat. 32`01'19.2" Long. 80°51'38.1" Horizontal Datum:
A6. Attach at least 2 photographs of the building if the Certificate is being used
A7. Building Diagram Number
A8. For a building with a crawlspace or endosure(s):
a) Square footage of crawlspace or enclosure(s) 1.871 sq ft
b) Number of permanent flood openings in the crawlspace
or enclosure(s) within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? ❑ Yes E No
Residential
❑ NAD 1927 ® NAD 1983
to obtain flood insurance.
A9. For a building with an attached garage:
a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage
within 1.0 foot above adjacent grade
c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? ❑ Yes ❑ No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
City of Tybee Island 135164
B2. County Name
Chatham
B3. State
Georgia
84. MapiPanel Number
13051CO213
Bb. Suffix
F
B. FIRM Index Date
9 -26 -2008
B/. FIRM Panel
Effective /Revised Date
9 -26 -2008
B8. Roos
Zone(s)
VE
89. Base Flood Eievauon(s) (Zone
AO, use base flood depth)
14.0
B10. Indicate the source of he Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other /Source:
811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other /Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date: ❑ CBRS ❑ OPA
❑ Yes ® No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1 Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction* E Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR /AE, AR /A1 -A30, AR/AH, AR /AO. Complete Items C2.a -h
below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: eGPS Vertical Datum: NAVD88
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 I NAVD 1988 ❑ Other /Source:
Datum used for building elevations must be the same as that used for the BFE.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
Check the measurement used.
6.6 E feet ❑ meters
16.2 0 feet ❑ meters
15.2 E feet ❑ meters
N/A ❑ feet ❑ meters
15.8 E feet ❑ meters
5.5
6.0
N /,A
E feet ❑ meters
E feet ❑ meters
❑ feet ❑ meters
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 on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here if attachments. licensed land surveyor? E Yes ❑ No
Certifier's Name J. Craig Brewer, RLS License Number 3022
Title Registered Land Sur Company Name Brewer Land Surveying
Address P 0. Box 441
City Pooter State GA ZIP Code 31322
Signature
Date 9 -19 -2013 Telephone 912- 856 -2205
FEMA Form 086-0-33 (7/12) See reverse side for continuation.
Replaces all previous editions.
ELEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.Q. Route and Box No.
17 Sanctuary Place
City Tybee Island State GA ZIP Code 31328
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number.
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 The elevation in section C2e is the outside air conditioning unit.
Signature
Date 9 -19 -2013
SECTIOJI- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone 0 and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B,
and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters 0 above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG,
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or 0 below the HAG.
E5. 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 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. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owners 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 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. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters.
G1 ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ 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. ❑ The following information (Items 04 -010) is provided for community floodplain management purposes,
G4. Permit Number
G5. Date Permit Issued
G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
GB. Elevation of as -built lowest floor (including basement) of the building:
G9. BFE or (in Zone AO) depth of flooding at the building site:
G10. Community's design flood elevation:
❑ feet ❑ meters Datum
❑ feet ❑ meters Datum
❑ feet ❑ meters Datum
Local Official's Name
Community Name
Signature
Comments
Title
Telephone
Date
J1 Check here if attachments.
FEMA Form 086 -0-33 (7/12)
Replaces all previous editions.
ELEVATION CERTIFICATE, page 3
Building Photographs
See Instructions for Item A6.
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.
17 Sanctuary Place
Policy Number:
City Tybee Island
State GA ZIP Code 31328
Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
Front & Right Side View 9 -19 -2013
Front & Left Side View 9 -19 -2013
FEMA Form 086 -0 -33 (7/12)
Replaces all previous editions.
Note: The V Zone design certificate is not a substitute for the NFIP Elevation Certificate (see Fact Sheet No.
1.4, Lowest Floor Elevation), which is required to certify as -built elevations needed for flood insurance rating.
Name John and Betsy Rabun
Building Address of Other Description
Permit No. 13 -0030
V ZONE DESIGN CERTIFICATE
Policy Number (Insurance Co. Use)
17 Sanctuary Place
City Tybee Island State GA Zip Code 31328
SECTION I: Flood Insurance Rate Map (FIRM) Information
Community No. 1335164 Panel No.0213 Suffix F FIRM Date 09/26/2008 FIRM Zone(s) VE -14
SECTION II: Elevation Information Used for Design
[NOTE: This section documents the elevations/depths used or specified in the design — it does not document surveyed elevations
and is not equivalent to the as -built elevations required to be submitted during or after construction.]
1. FIRM Base Flood Elevation (BFE) 14.0 feet*
2. Community's Design Flood Elevation (DFE) 15.0 feet*
3. Elevation of the Bottom of Lowest Horizontal Structure Member 15.2 feet*
4. Elevation of Lowest Adjacent Grade 5.5 feet*
5. Depth of Anticipated Scour /Erosion used for Foundation Design 3.0 feet
6. Embedment Depth of Pilings of Foundation Below Lowest Adjacent Grade 43 to 47 feet (pile depth varies) feet
* Indicate elevation datum used in 1-4: ❑ NGVD29 El NAVD88 ❑ Other
SECTION III: V Zone Design Certification Statement
I certify that: (1) I have developed or reviewed the structural design, plans, and specifications for construction of the above -
referenced building and (2) that the design and methods of construction specified to be used are in accordance with accepted
standards of practice ** for meeting the following provisions:
• The bottom of the lowest horizontal structural member of the lowest floor (excluding piles and columns) is elevated to or above
the BFE.
• The pile and column foundation and structure attached thereto is anchored to resist flotation, collapse, and lateral movement due
to the effects of the wind and water loads acting simultaneously on all building components. Water loading values used are those
associated with the base flood * * *. Wind loading values used are those required by the applicable State or local building code. The
potential for scour and erosion at the foundation has been anticipated for conditions associated with the base flood, including
wave action.
SECTION IV: Breakaway Wall Design Certification Statement
[NOTE. This section must be certified by a registered engineer or architect when breakaway walls are designed to have a
resistance of more than 20 psf (0.96 kN /m2) determined using allowable stress design]
I certify that: (1) I have developed or reviewed the structural design, plans, and specifications for construction of breakaway walls to
be constructed under the above - referenced building and (2) that the design and methods of construction specified to be used are in
accordance with accepted standards of practice *` for meeting the following provisions:
• Breakaway wall collapse shall result from a water load Tess than that which would occur during the base flood * * *.
• The elevated portion of the building and supporting foundation system shall not be subject to collapse, displacement, or other
structural damage due to the effects of wind and water loads acting simultaneously on all building components (see Section III).
SECTION V: Certification and Seal
This certification is to be signed and sealed by a registered professional engineer or architect authorized by law to certify
structural designs. I certify the V Zone Design Certification Statement (Section III) and ✓ the Brea ayr.Wp11 �e '•n
Certification Statement (Section IV, check if applicable).
Certifier's Name Neil Dawson, AIA
Title
Address
City
Signature
President
1020 Bryan Woods Loop — Suite 1
License Number Georgia AR -9731
Company Name Dawson Architects
State GA Zip Code 31410
Date Telephone 912 - 695 -2111