HomeMy WebLinkAbout5000 Solstice LpU.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 FOR,INSURANCE COMPANY USE;
Al Building Owner's Name GS /AE Southgate LLC Policy Number:
A2 Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No Company NAIL N..umber:
5000 Solstice Loop
City Sanford State FL ZIP Code 32771
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc )
Building 5 at Parcel 9, Southgate Property PB 77, PGS 8 -10
A4. Building Use (e g., Residential, Non - Residential, Addition, Accessory, etc )Residential
A5. Latitude /Longitude: Lat. 28 48 12.00 Long -81 20 04.41 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 1B
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) sq ft a) Square footage of attached garage 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 within 1 0 foot above adjacent grade
c) Total net area of flood openings in A8 b sq in c) Total net area of flood openings in A9 b sq in
d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1 NFIP Community Name & Community Number B2 County Name B3. State
City of Sanford & 120294 Seminole FL
B4. Map /Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8 Flood B9. Base Flood Elevation(s) (Zone
0065 F Sept. 28, 2007 Effective /Revised Date Zone(s) AO, use base flood depth)
Sept 28, 2007 X Unshaded
B10. 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:
B11. 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)? O 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, Vl —V30, V (with BFE), AR, ARIA, AR/AE, AR /A1 —A30, AR/AH, AR/AO. Complete Items C2.a —h
below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Benchmark Utilized: GPS0296 Vertical Datum: NGVD 29
Indicate elevation datum used for the elevations in items a) thrOUgh h) below ® NGVD 1929 O 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) 41.51 ® feet ❑ meters
b) Top of the next higher floor ❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ meters
d) Attached garage (top of slab) ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 41.34 ® feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 40 7 ® feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 42 8 ® feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support ❑ 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
y,
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
1009.
l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
[_1 Check here if attachments. licensed land surveyor? 0 Yes [I No
a } 1 `
'
Certifier's Name David A. White License Number LS 4044
Title President Company Name PEC - Surveying & Mapping, LLC
Address 2100Alafaya Trail City Oviedo State FL ZIP Code 32765
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Signature Date 10 -07 -14 Telephone 407 - 542 -4967
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. FOR INSURANCE;COMPANY USE
Building Street Address (including Apt, Unit, Suite, and /or Bldg_ No.) or P O Route and Box No. Policy N,
5000 Solstice Loop
City Sanford State FL ZIP Code 32771 CompanyNAIC'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 C2e is a A/C Pad
Signature Date 10 -07 -14
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 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
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
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 ❑ 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 owners 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
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 G4 -G10) 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
G8. 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
G10 Community's design flood elevation: ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
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.
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P O. Route and Box No
City
State ZIP Code
FOR INSURANCE COMPANY USE
Policy Number.
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_
FEMA Form 086 -0 -33 (7/12) Replaces all previous editions.
ELEVATION 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., Unit, Suite, and /or Bldg No ) or P O. Route and Box No Policy Number:
City State ZIP Code Company NAIL 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'; 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.
FEMA Form 086 -0 -33 (7/12) Replaces all previous editions.