HomeMy Public PortalAboutBUTLER AV_705.pdfU.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
Nutional Fluod buiirusia I'vogram
Al
Lacey
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-9
SECTION A - PROPERTY INFORMATION
OMB No. 1660-0U08
Expiration Date July 31, 2015
FOR INSURANCE COMPANY USE
Policy Number
A2. Building Street Address (including ApL, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company mw Number:
#705 Butler Avenue
City Tybee Island
State GA ZIP Cade 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 12A, Ward 2 Tybee Island, Tax Parcel #4-0005-19-005
A4. Building Use (e.g.. Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat, 32°00'11.9" Long. 80°50'46.7" Horizontal Datum: ❑ NAD 1927 ® 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 8
A8. For a building with a crawlspace or enclosure(s): AS For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 1,400 sq 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 2� within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b 4.$00 sq in c) Total net area of flood openings in A9.b NIA sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
131. NFIP Community Name & Community Number 82. County Name 83. State
City of Tybee Island 135164 Chatham Georgia
B4. Map/Panel Number B5. Suffix B6, FIRM Index Date B7. FIRM Panel B8. Flood B9 Base Flood Elevation(s) (Zone
13OSICO213 F 9-26-2008 Effective/Revised Date Zone(s) AO, use base flood depth)
9-26-2008 AE 12
810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
811. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source.
812 Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
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. Elevations -Zones Al -A30. AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA. ARAE, AR/A1-A30, ARIAH, ARIAO. Complete Items C2.a-h
below according to the building diagram specified in Item A7 In Puerto Rica only, enter meters.
Benchmark Utilized: eGPS Vertical Datum: NAVD88
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source:
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, craWspace, or enclosure floor) 94
® feet
❑ meters
b) Top of the next higher floor 12.Q
® feet
❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/,A
❑ feet
❑ meters
d) Attached garage (top of slab) N/.A
❑ feet
❑ meters
e) Lowest elevation of machinery or equipment servicing the building 9.2
® feet
❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 8.4
® feet
❑ meters
g) Highest adjacent (finished) grade next to building (HAG) -1.9
® feet
❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 9.6
® 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. I certify that the information on this Certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1007.
.
® 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? ® Yes ❑ No
Certifiers Name J. Craig Brewer, RLS License Number 3022
Title Registered Surveyor Company Name Brewer Land Surveying
Address P.O. Box 441
Signature
FEMA Form 086-0-33 (7112)
City Pooler State GA ZIP Code 31322
adte.10-26-2013 Telephone 912-836-2205
See reverse side for continuation.
No, 3o22
POFESSIONAL
'r
Replaces all previous editions.
ELEVATION CERTIFICATE. I)atae 2
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.Q. Route and Box No. Policy Number:
#705 Butler Avenue
City Tybee Island State GA ZIP Code 31328 1 Company NAIC Nurmber.
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 area in Section A8 and the elevation in Section C2a is the crawlspace bottom. The elevation in Section C2e is the outside air conditioning
unit.
Signature r 1 Date 10.26-2013
SECVINY- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOtIT Rt=1=t
For Zones AO and A (without BFE), complete Items EI -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.
E1. 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 ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG,
F..2. 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 ❑ below the HAG.
E5 Tone 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 Owner's or Owners Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ L 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,
Gl. ❑ 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 G4 -G1 0) is provided for community floodplain management purposes.
G4. Permit Number I G5, Date Permit Issued I G8. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G3. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G 10. Community's design flood elevation: ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Ch2a 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. Policy Number:
#705 Butler 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 the instructions
for Item A6. Identity 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 ft on this page, use the Continuation Page.
FEMA Form 086-0-33 (7112) Replaces all previous editions.