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HomeMy Public PortalAboutSecond Av_707U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Mmrwal f, IrA W lnNurumv Program Important, Read the his trill ctions on pages 1-9. Al BuMing Owner's Name Amy Green . ... ......... . .. .... A2. Buillding Street Address (including Apt., Unit, Suite, and/or Bldg No,) or P.O. Route and Box No. 707 Second Avenue City 'TybIee Island State GA ZIP Code 31328 Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) lot 63-A. ward 2 DDB o 60-0008 Expiration fate: 31, 20 B 'i E ati0on Date: Jul FFOR INSURANCE COMPANY JSE i-MB%umm A4, Building Use (e.g., Residential, Non. Residential, Addition, Accessory, etc,) Residential A5. Latnude/Longii Lat. N 32 dent 041.2'980 min Long WIC AQ_dgg_,50.7540 min Horizontal Datum: ❑ NAD 1927 Z NAD 1983 AIS. Attach at least 2 photographs of thebuilding if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 A8 For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) !Lla sal ft a) Square footage of attached garage n/a sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade Pla within 1,0 foot above adjacent grade n1a c) Total net area of flood openings in A8rb nl—q sq in c) Total net area of flood openings in A9.b n✓a ad in d) Engineered flood openings? ❑ Yes 0 No d) Engineered flood openings? ❑ Yes No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION FE�iIP Community Name & Community Number 2. B3. State I Tybee Island 135164 ] �ChaCthaU GA , N That B2. County Name �B6FIRI n' B8. Flood B9r Base Flood! Elievartion(s) Gone B4. Map/Panel bor B5. Suffix 'ff 137- FIRM pane 13051 CO213 F III Mi 4 Fffe isel Dale Zone(s) AO, use base flood depth) �Umbor 9126108 AE 11 .. . - . �11 -_,SF U I B10, indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile N- FIRM ❑ Community Determined F-I Cther/Source� 1311. Indicate elevation datum used for BFE in ftern Ei ❑ 11929 MX NAVD 1988 Eli Other/Source: B12, Is the building located in a Coastal Barrier Resources System (CBRS) area air Otherwise Protected Area (OPA)? Yes ❑ No Designation Date: ❑ CBRS ❑ OPA SECTIO14 C — BUIli 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, Elevations — Zones Al—A30, AE, APT, A (with BFE), VE, VI—V30, V (with BFE), AR, AR/A, AR/AE, ARIA1 —A30, Ai 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: loca) Verticai Datum: NAVID 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 0 NAVD 1988 ❑ OtherlSource, Datum used for building elevations must be the same as that used for the BFE Check the measurement used a) Top of bottom floor (Including basement, crawispace, or enclosure floor) 13.9 feet ❑ meters, I Top of the next higher floor 14 feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) n/a--rl feet meters d) Attached garage (top of slab) n/a.. feet 0 meters e) Lowest elevation of machinery or equipment servicing the building 139 feet ❑ rnei (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to building (I.AG) 11,6 [Z feet ❑ meters g) Highest adjacent (finished:) grade next to building (HAG) I2 0 Z, feet 0 meters h) Lowest adjacent grade at bwest elevation of deck or stairs, including structural support 11.6 J feet ❑meters SECTION D — SURVEYOR, ENGINEER, OR ARCIAITECT CERTIFICATION This certification is to be signed and sealed by a land Surveyor, engineer, or architer,[ authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts fa interpret the data avaiiable. I understand that any false staler vnif r,783' be puniishablie by flee or, iniprisonirverif under 18 U.S Code, Section 1001. Lj El Check here if comments are provided on back of form Were latitude and lOngitiOde in Section A provided by a IV Check here if attachments. licensed land surveyor? Z Yes No Certifier's Name J. Whitey Reynolds License Number 2249 r Title Land Surveyor Company Name Add" State GA ZIP Code 31405 City Savannah 63C 'S' in his nT 0, t n on enue Tale 9"23-04 64 Signature 'Date 7/10115 phone -52 i Form 086-0-3,3 (7112) See reverse side for continuation. RepCaces all previous editions. -4 ........... IMPORTANT: In these spaces, copy the corresponding information from Section A, FOR INSURANCE COMPANY USE Buflding Street Address (including Apt., Unit, Suite, and/or BIdg. No.) or Pro' !Route and Box No. Policy Number 707 Second Avenue ... ............... City Tybee Island State GA ZfP Code, 3,1328 Company NAIC Number: SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official (2) insurance @genucompany, and (3) building owner. Comments C2.a) is utility room. A/C pad s elev. 19,0. Sign4tore Date 7110115 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without WE), complete Iterris E1-E5r if the Certificate is Intended to support a LOMA or LOMR-F request, cornplete Sections A, 6, and C. For Items E1-E4, use natural grade, if available Check the measurement used, In Puerto R co only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevafion is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG)r a),rop of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters E] above or ❑ below the HAG, b) Top of bottom floor (including basement, crawlspace, or enclosure) I,,, ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 15-9 with permanent flood openings provided in Section A lterne 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrarns) of the buildings . _ ❑ feet ❑ meters ID 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 ❑ 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 floodpla.'rl 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 FEIVIA-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 Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Comments 'Telephone Lj Qjggk here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain managernent ordinance can complete Sect-ions A, 3, C (or E), and G of this Elevation Certificate. Complete the applicable rem(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 cornpleted Section E for a building located in Zone A (without a FEMA-issued or community-issued 3FE) or Zone AO G3, ❑ The following information (items G4-G10) is provided: for community fioodpiain management purposes. G4r Permit Number... ..._.. __... _ ...... _- .... . G5. Date Permit issued �­66. �Date Certificate Of ComplianceYOccupancy Issued G7. This permit has been issued for: ❑ tqew Construction ❑ Substantial Improvement 08 Elevation of as -built lowest floor (including basement) of 1he building: ❑ feet [D meters Datum G9r BFE or (in Zone AO) depth of flooding at the building site: feet ❑ meters Daturn G10, Community's design flood elevation: ... . .... ... ❑ feet ❑ meters Datum Local Official's Name ComirnunAy Name Signature - - .... . . . . .... Connirrients M11 Telephone Date Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous - e - d -- i - t - i I o "" in " s ELEVATION CERTIFICATE, page 3 Building Photographs See �nstructions for ft-&ii A6. IMPORTANT. In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE _....._._...m._........ Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 707 Second Avenue 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 tile lristructions for Itern A6, Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View," When apphcable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated In Section A8. If submitting more photographs than w0l fit on this page, Use the Continuation Page. FEMA Form 086-0-33 (7/12) Replaces all previous, editions. ELEVATION CERTIFICATE, page 4 Building Photographs Confinuation Page IMPORTANT.- ln these spaces, copy the corresponding information from Section A. Building Street Address (inVuding Apt., Unit, Suite, and/or Ddg. No.) or P.O. Route and Box No,. 707 Second Avenue City Tybee Island State GA ZIP Code 31328, FOR ONSURANCE COMPANY USE Policy Number! Company NAIC Nurnber: .. ..... ............... If submitting more photographs than MH fit on the preceding page, aiffix the additional photographs below. identify all photograp tca Mth: date taken� "Front V�ew" and "Rear View"; and, if required, "Right Side View" and "Left Side VieWr" When applicabi 'Ppl photographs must show the foundation with representative examples of thenood openings or vents, as ind�cated in Section AS. . . .............. .. _ j . . . ..... . . ... .... ... ;Par ViPw.hjlv A 9n11,S FE MA Form 086-0-33 (7/Q) Replaces all previous editions.