Loading...
HomeMy Public PortalAboutJONES AV_503.pdfU.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: ,July 31, 2015 SECTION A - PROPERTY INFORMATION ;ORJ[SItANfvE(ftE? Y USE Al, Building Owner's Name JAMES I. & CAROL M. SCOTT POtiay NLtinber A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Gatttftap+NAtC tduintler 503 JONES AVENUE City TYBEE ISLAND State GA 71P Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 104, WARD 2, TYBEE ISLAND A4. Building Use.(e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat..32.00826 Long. 80.84541 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. AT Building Diagram Number 6 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 483 sq ft a) Square footage of attached garage NIA sq R 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 3 within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in A8.b 600 sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ® Yes ❑ No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name &Community Number B2_ County Name 83. Slate TYBEE ISLAND, GEORGIA - 135164 CHATHAM GA B4. MaplPanel Number 85. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevations) (Zone 13051 CO213 F 7/07/2014 EffectivelRevised Date Zones) AO, use base flood depth} 9!26!08 AE 11 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ OtherlSource: 1311. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date: NIA ❑ 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 Ai -A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, ARIA1-A30, AR/AH, ARIAO. Complete Items C2.a-h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: eGPS VRS NETWORK 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, crawlspace, or enclosure floor) 9.t ® feet ❑ meters b) Top of the next higher floor 19.0 ®feet ❑meters p6 5K c) Bottom of the lowest horizontal structural member (V Zones only) N/A.- ® feet El meters \� d) Attached garage (top of slab) NONE._ ® feet C1 meters\D Op Z e) Lowest elevation of machinery or equipment servicing the building $.9 ® feet ❑ meters r (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) 8.8 ® feet ❑ meters �nl h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 8.7 ® 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. GGOR I understand that any false statement may be punishable by fine or imprisonment under 16 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 1S7 ry F1 Check here i# attachments. licensed land surveyor? ® Yes ❑ No Qom::;.; ;, �10 Certifier's Name BERT B. BARRETT, JR License Number GA. 2225 W 2225 Title OWNER/PRESIDENT Company Name BERT BARRETT, JR LAND SURVEYING PC Address 145 RUNNER ROAD City SAVANNAH State GA ZIP Code 31410 Signature %",\ Date 4115116 Telephone 912-897-0661 FEMA Form 086-0-33 (7112) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Section A. i €fit NSURANCS CQiAPANY USE Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P-0. Route and Box No.cit-r 503 JONES AVENUE City TYBEE ISLAND State GA ZIP Code 31328 Ctt#rrty 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 1. GOOGLE EARTH USED TO OBTAIN LATILONG, 2, THE ELEVATION SHOWN IN C2 e) IS THE OUTSIDE HEATPUMP UNIT (CONDENSOR). 3_ THE ENGINEERED VENTS ARE ALL SMART VENTS WITH THE FOLLCWiNG SERIAL NUMBERS, 57038745, S7038757 & S7038758. Signature Date 4115116 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items EI -E6. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, 6, and C. For Items Et -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide eievation 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 NIA. ® feet ❑ meters ❑ above or ❑ below the HAG_ b) Top of bottom floor (including basement, crawlspace, or enclosure) is NIA. ® feet ❑ meters ❑ above or ❑ below the LAG_ E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 andlor 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is NIA. ® feet [:1 meters © above or ❑ below the HAG. E3. Attached garage (top of slab) is NIA. ® feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is NIA. ® 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 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 Owner's Authorized Representative's Name NIA Address NIA City NIA State NA ZIP Code N/A Signature NIA Date NIA Telephone NIA Comments NIA U 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, S, C (or E), -—and of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items Ga -GI 0. 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 G4 -G10) is provided for community floodplain management purposes. G4. Permit NumberI N . Date Permit Issued G6. . Date Certificate Of CompliancelOccupancy Issued NIA G7. This permit has been issued for: ❑ New Construction CJ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: NIA. ® feet ❑ meters Gg. BFE or (in Zone AO) depth of flooding at the building site: NIA. ® feet ❑ meters G10. Community's design flood elevation: NIA. ® feet ❑ meters Local Official's Name NIA Community Name NIA Signature NIA Comments NIA Title NIA Telephone NIA Date NIA Datum Datum Datum Check here if attachments FEMA Form 086-0-33 (7/12) Replaces all previous editions.