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Home My Public Portal AboutTENTH PL_5.pdfU.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 Man0=1 1loud hisura,rice llrugraiyf Important. Read the instructions on pages 1-9, Expiration Date: July 31, 2015 SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Howard Levy & Faith Levy Policy Number: Building Street Address (including Apt., Unit, Suite, andior Bldg. No.) or P.O. Route and Box No. Company NAC Number. 5 Tenth Place ___Z,ty �Tyb.e tiand State CA ZIP Code 31328 Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description. etc.) lot A of a recombination of lots A, B, C-1 & C-2 of front lot 65, ward 4 PIN 4.006-18-018 A4 Building Use (e.g,, Residential, Non -Residential, Addition, Accessory, etc.) ELe5identral A5 Latitudell-ongitude- Lat. N.31 deg 59.9740 min Long. LNg2A�t50,1180 min Horizontal Datum: 171 MAD 1927 0 NAD 1983 A6 Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance A7 Building Diagram Number 6 A8 For a building with a crawlspace or anclosure(s): AS. For a building with an attached garage a) Square footage of crawlspace or enclosure(s) 283 sq ft a) Square footage of attached garage We act ft b) Number of permanent flood openings in the crawispace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade 2 within 1 0 foot above adjacent grade ritlai c) Total net area of flood openings in A8.b 400 sq in c) Total net area of flood openings Mn A9.b We so in d) Engineered flood openings? M Yes E] No d) Engineered flood openings? _1 Yes No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number 'd �nty B3 State Tybee Island 135164 Chatham GA Panel Flood FF�_Maplp-llel Number B5 Suffix 66r 'IRM Index B9 Base Flood Elevation(s) (Zone 13051CO213 F 7/7114 EffectivelRevised Date Zons(s) AOUS"ar b 'loud depth) 1" 9/26108 AE 130 B10. Indicate the source of the Base Flood Elevation o3FE), data or base flood depth entered in Item B9. F.j FIS. Profile FIRM E] Community Determined El O;herlSovrce:0 1311. Indicate elevation datum used for FIFE in Item 89: F1 NGVD 1929 R NAVD 1988 0 OtherlSource B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes Z No Designation Date: [] CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Sufldbng elevations are based on: 0 Construction Drawings* E] Building Under Construction' 0 Finished Construction 'A now Elevation Certificate will be required when construction of the building is complete, C2. Elevations --Zones Al -A30, AE, AH. Agwth SFE), VE, V1-430, V (with BFE), AR, ARIA, AR)AE, ARAI-A30, ARAH, ARIA0 Complete Items C2 a -h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: local Vertical Datum:AV "8 N , ''. qrl Indicate elevation datum used for the elevations in items a) through h) below, 0 NGVD 1929 FJ NAVID 1988 El OlhorlSource: Datum used for building elevations must be the same as that used for the 81`17. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, of enclosure floor) 100.1 Z feet L] meters b) Top of tlhe next higher floor 19-1 N feet 0 meters c) Bottom of the lowest horizontat structural member (V Zone*. only) M feet F1 meters d) Attached garage (top of slab) i-19 M feet [_1 meters a) Lowest elevation of machinery or equipment servicing the building 14 .7 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) Z feet 0 meters g) Highest adjacent (finished) grade next to building (HAG) 8 6 0 fe0 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support .78 9 feet 0 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 Cointerprot the data information. I certify that the information on this Cedilrcate represents my best efforts available. I understand that any false, statement may be punishable by fine or ffriprisooment under 18 U. S. Code, Section fool C)R " [_] Check here if comments are provided on back of forrin Were latitude and longitude in Section A provided by a ❑Check here if attachments. licensed land surveyor? N Yes No Carlifier's Name J. Whitley Reynolds License Number 2249 s -LL'4 Title LaridSurvroyer„ Company Name ,8, Address 636,,Stepho,son Ave Signature,' City Savannah Date 3129/16 State CA ZIP Code 31405 11 _1_______- -- — -------- Telephor)L 912-352-0464 FEMA Forrin,086-0-33 (7612) See reverse side for continuation. Replaces all previous editions. IMPORTANT: In these spaces, copy the corresponding information from! Section A. FOR ... I .. N .. S ... URAN . CE ... COMPANY .. USE --- Building Street Address (including Apt., Unit, Suite, and/or Bldg No) Or P.O. Route and Box No.. Policy Number: 5 Tenth Place City Tybee island State GA ZIP Code 31328 Company NA1jC 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 C2 e) is A/C pad 02.a) has 2 engineered flood openings. Smart Vent 1540-510 Signatur Date 3129/16 rf SECTIOPIE - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BEE) For Zones AO and A (without OFE), complete Items E1 -E5. If the, Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and Cr For Items EI -E4, use natural grade, 0 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 lincluding basement, crawlspace. or enclosure) is ..... . D feet El mete�,, .... above or D below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is 0 feet El meters El above or El below the LAG, E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages &--9 of I nishurlions), the next higher floor (elevation C2_b in the diagrams) of the building is L1 feet FI meters E] above or f.] below the HAG. E3. Attached garage (top of slab) is __ Ofeet (Imeters Elabove m F below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is n- feet ❑I meters 0 above or El below the HAG, E5. Zone AO onlyr 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 [J No E] 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 commurilty-tissued BFEy 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 Guide . .. ........ Signature Date Telephone Comments hqcK hrpre if attachrinqns. SECTION: G - COMMUNITY INFORMATION (OPTIONAll The local official who is authorized bylaw or ordinance to administer the community's floodplain managementordinancecan complete Sections A, 13, C (or E), and G of this Elevation Certificate, Complete the applicable item(s) and sign below. Check the measurement used in Items G6 -G10. in Puerto Rico only, enter meters. G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who Ps 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 Q1 ❑ The following information (items G4 -G10) is provided for community floodplain management purposes. 4. Permit Number Date Permit Issued G6, Date Certificate Of CompliancelOccupancy Issued G7. This permit has been issued for: El Now Construction LJ Substantial Improvement G8r Elevation of as -built lowest floor (including basement) of the bl.lildrrg.E] feet E]mete -rs Datum G9 BEE or (in Zone AO) depth of flooding at the building site: u rJ feet E] meters Datum G10. Community's design flood elevation: 0 feet 0 meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments FEMA Form 086-0-33 (7112) Check here it attachments Replaces all previous editions, ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. 7 --- .... . .. .. . .. ........ IMPORTANT: In thes a spaces, copy the corresponding Information from Section, A. FOR NSURANCE COMPANY USE Building Street Address (including Apt„ unit, Suite, and/or Bldg,. Nlo.) or P.O. Route and Box No PoAcy Number 5 Tenth Place City Tyree Island State GA ZIP Code 31328 Company MAIC 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 MeW 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 View March 28, 2016 J: . .... ....1!! 1101111 ,y t"IMN PIYY�VNNuMIVu All FEMA Form 086-0-33 (7112) Replaces ail previous editions, 5LEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding: information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unh. Suite, andfor Ndg. No.) or P.O. Route and Box No. 5 Tenth Place Policy Number City Tybee Island State GA ZP Code 31328 1 Company MAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; arid, 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. FFMA Form 08"-33 (7/12) Replares all previous editions. I ''I'll'' — I