HomeMy WebLinkAbout1321 Shepherd Ave; 17-2012; HEAT PUMP & EXHAUST FANCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
F
Application No: 7 i f 2
Documented Construction Value: $ 3 5 1)0
Job Address: _- 2 J 9 / A, 0 IA U O t'J' if P Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repai''r// Demo El Cjh ange ofQUse Move
Description of Work: I A S4 4 G 1 1 12 -f 9 n
2 ('mat C v oi1an - f>ryev UiJrlfi hrJ RED
Plan Review Contact Person: Title:
Phone: 4 nV-195 ` 4 Fax: Email: t`y # I r 1 n C 04 G- h' ed .170
Property Owner Information
Name Phone:
Street:
City, State Zip:
Name Y ' - p 1 F t- `n
Resident of property? :
Contractor Information
Street:
City, State Zip: D r- I09'/1
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Phone: 40 7 lf'v
Fax:
State License No.: C 1} C D (S P7'
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction
in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, heaters, tanks, and air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 51' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulatin construction and zoning.
i wdw J 0
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print Contractor/Agent's Name
d5t&, ,—
rgnature of Notary -State of Florida Date
DEBBIEBLANTON—
h4Y COMMISSION it FF 178648
u EXPIRES: February 25, 2019
F3onded Thru Noiary Public Underwriterso--
Contractor gent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads
UTILITIES:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
7/28/17
All Bids & Quotes Expire 30 Days from date on proposal.
1 1 15 S. Crystal Lake Dr. • Orlando, FL 32806 • Office 407-485-9300 • Fax 407-641-8774 • pdairinc@gmail.com • pdairinc@aol.c
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
D
Application No: 7— 7—
Documented Construction Value: $ Glpz . b 0
Job Address: 13 71 f 4° V4 1% t Historic District: Yes No
Parcel ID: ResidentiaZ Commercial
Type of Work: New,® Addition Alteration Repair Demo Change of Use Move
Description of Work: e G(e-"'4 k"—G
Plan Review Contact Person:
Phone:
Name
Street:
City, State Zip:
Fax:
Title:
Email:
Property Owner Information ,
Phone:
Resident of property?
Contractor Information
Name A f7, L5'T --" 9-J'0 Phone: Ik07— 57-(7 _ LkOP7 Street:
f ,0 _ 5,7K 5 -.' C' Fax: City,
State Zip: _5'14-- FO X p c r - `S Z 777 State License No.: Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
WARNING
TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Application
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced
prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in
this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces,
boilers, heaters, tanks, and air conditioners, etc. FBC
105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5'h Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Lc
I .&
1
6 9.
gnature of Notary -State of Florida Date
77, DFBBIF BLAWON
I{Fe{oU ry2572G48EXPIRE2019
IDondedTh:u IJotaiy Public Undenvriiers
Contractor/Ae#i isfers_ona y Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas Roof
Construction Type: Occupancy Use: Flood Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
A
L
PLUMBING
Cert. # CFC 041740
P.O. BOX 336 OFFICE (407) 321-6437
SANFORD, FL 32772-0336
PROPOSAL SUBMITTED TO: DATE
KITCHEN
ICE MAKER
DISHWASHER f_6c P__ tx04
SINK
VALVE
S. 1
A- d -e ,-t- C. 4 (2-p -0-
WASTER BATH
WATER CLOSET
SHOWER Px _ i, o
LAVATORIES
TUB 51" f (- - L r '' —
DISPOSAL O.,.<- 17 f7-eX eZ OTHER
LAUNDRY
WASHING MACHINE
LAUNDRY TUB
A/C CHASE -
WATER HEATER
OTHER
GUEST BATH
WATER CLOSET / C
TUB S``'..e. P L ,,— I / t t'
LAVATORY q A-0,0 '-
HOSE BIBS 2
SEWER 5-O
WATER S d
Or Propose hereby to furnish material and labor- in accordance with above specifications, forthe sum of:
5 1 x T- (I ollars ($-aOOP67 . c0
i
All material Is guaranteed to be as specified. All work to be completed In a workmanlike
manner according to standard practices. Any alteration or devlatlon from above speclllca-
tlons Involving extra costs will be executed only upon written orders, and will become an
extra charge over and above the estlmale. All agrrements contingent upon slrikaa;'eccldenls
or delays beyond our control. Owner to terry fire, tornado and other necessary Insurance
Our workers are fully covered by workman's Compensation Insurance.
JNrcerfanc.e of. roposMl -The above prices,
specificat ons and conditions are satisfactory and are hereby
specifications and conditions are satisfactory and are hereby
accepted. You are authorized to do the work as specified. Payment
will be madess outlined above. All collection or arbitration expenses,
attorneys' fees, and court costs will be borne by the purchaser.
Date of Acceptance (— 1-t - ( 7—
Authorized
Signature --
NOTE: This proposal may be
withdrawn by usJ4\not accepted within 30 days.
Sigrinflire
s
FLORIDA ENERGY EFFICIENCY CODE
FOR BUILDING CONSTRUCTION
2014 Envelope Leakage Test Report
Prescriptive and Performance Method
Project Name: KATTIE YOUNG MJS 010918 Builder Name:
Street: 1321 SHEPARD AVE Permit Office:
City, State, Zip: SANFORD , FL, 32771 Permit Number:
Design Location: FL, Sanford Jurisdiction:
Cond. Floor Area:: 1001 sq.ft. Cond. Volume: 8008 cu ft.
Envelope Leakage Test Results
Regression Data:
C: 73,2969 n: 0.65 R: N/A
Single Point Test Data:
HOUSE PRESSURE FLOW:
50.0 932.0 cfm
Leakage Characteristics
CFM(50): 932.0
ELA: 51.166
Eq LA: 96.224
ACH: 0.2591
SLA: 0.00035
ACH(50) " : 6.9830
For prescriptive projects, tested leakage must be
7 ACH(50). For performance projects, tested
leakage must be <= the ACH(50) shown on Form
R405-2014 for this project.
R402.4.1.2 Testing. The building or dwelling unit shall be tested and verified as having an air leakage rate of not exceeding 7 air changes per hour
in Climate Zones 1 and 2 ... Testing shall be conducted with a blower door at a pressure of 0.2 inches w.g. (50 Pascals). Testing shall be conducted by
either individuals as defined in Section 553.993(5) or (7), Florida Statutes or individuals licensed as set forth in Section 489.105(3)(q, (g), or (i) or an
approved third party. A written report of the results of the test shall be signed by the party conducting the test and provided to the code official. Testing
shall be performed at any time after creation of all penetrations of the building thermal envelope.
During testing:
1. Exterior windows and doors, fireplace and stove doors shall be closed, but not sealed, beyond the intended weatherstripping or other
infiltration control measures;
2. Dampers including exhaust, intake, makeup air, backdraft and flue dampers shall be closed, but not sealed beyond intended infiltration
control measures;
3. Interior doors, if installed at the time of the test, shall be open;
4. Exterior doors for continuous ventilation systems and heat recovery ventilators shall be closed and sealed;
5. Heating and cooling systems, if installed at the time of the test, shall be turned off; and
6. Supply and return registers, if installed at the time of the test, shall be fully open.
I hereby certify that the above envelope leakage
performance results demonstrate compliance
with Florida Energy Code requirements in
accordance with Section R402.4.1.2.
SIGNATURE:
PRINTED NAME:
MARGARET SIMS ER1
Where required by the code official,
testing shall be conducted by an
approved third party. A written
report of the results of the test shall
be signed by the third party
conducting the test and provided to
the code official.
BUILDING OFFICIAL:
DATE: 2018.01.09 13:57:08 --5 DATE:
1/9/2018 1:46 PM EnergyGauge® USA - FlaRes2014 - Section R405.4.1 Compliant Software Page 1 of 1
Legal Description:
Lot 35 and the North 1/2 of the Vacated Street on South, Block G, A.D. CHAPPELLS
SUBDIVISION, according to the Plat thereof, as recorded in Plat Book 1, page 71, of the Public
Records of Seminole County, Florida.
A B B R E V I A T 1 0 N L E G E N D
P.R.M. PERMANENT REFERENCE MONUMENT C.M. CONCRETE MONUMENT EL. ELEVATION CONC. CONCRETE
P.O.C. POINT OF COMMENCEMENT P.B. PLAT BOOK A/C AIR CONDITIONER C.L.F. CHAIN LINK FENCE
P.C. POINT OF CURVATURE Pg. PAGE TYP. TYPICAL W.F. WOOD FENCE
P.R.C. POINT OF REVERSE CURVATURE N.R. NON -RADIAL U.E. UTILITY EASEMENT C & G CURB & GUTTER
P.C.C. POINT OF COMPOUND CURVATURE RAD. RADIAL D.E. DRAINAGE EASEMENT CATV CABLE TELEVISION RISER
P.T. POINT OF TANGENCY R. RADIUS F.F. FINISHED FLOOR TELE TELEPHONE RISER
P.I. - POINT OF INTERSECTION L. ARC LENGTH B.S. BUILDING SETBACK TRANS TRANSFORMER PAD
P.C.P. PERMANENT CONTROL POINT 0 DELTA C.B.S. CONCRETE BLOCK STRUCTURE L.P. LIGHT POLE
P.O.L. POINT ON LINE R.P. RADIUS POINT P) PLAT P.P. POWER POLE
C.B. CHORD BEARING R/W RIGHT-OF-WAY M) MEASURED EM ELECTRIC METER
T.B. TANGENT BEARING CENTER LINE C) CALCULATED R/W RIGHT OF WAY
Survey Notes:
1. "NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A
FLORIDA LICENSED SURVEYOR AND MAPPER".
2. BEARINGS SHOWN HEREON ARE RELATIVE TO THE EAST LINE OF LOT 57,
BLOCK D AS BEING N 01'13'12" E AS SHOWN BEING ASSUMED.
3. THE "LEGAL DESCRIPTION" HEREON PER THE PUBLIC RECORDS OF SEMINOLE
COUNTY, FLORIDA.
4. THIS SURVEY WAS PREPARED WITHOUT THE BENEFIT OF AN ABSTRACT OR
OPINION OF TITLE. NO INSTRUMENTS OF RECORD REFLECTING EASEMENTS,
RIGHTS —OF —WAY, AND/OR OWNERSHIP WERE FURNISHED TO THIS SURVEYOR
EXCEPT AS NOTED.
5. ALL BEARINGS AND DISTANCES SHOWN HEREON ARE PER THE DESCRIPTION
AND ARE CORRECT AND IN AGREEMENT WITH THE FOUND AND SET MONUMENTS
AS MEASURED IN THE FIELD UNLESS OTHERWISE NOTED.
6. ACCORDING TO THE NATIONAL FLOOD INSURANCE PROGRAM, FLOOD
INSURANCE RATE MAP (FIRM) COMMUNITY PANEL NO. 12117CO07OF
EFFECTIVE DATE: SEPTEMBER 28. 2007. THIS PROPERTY LIES IN ZONE "A" LYING
INSIDE THE 100 YEAR FLOOD ZONE.
W.M. WATER METER
F.H. FIRE HYDRANT
N & D NAIL AND DISC
B.M. BENCH MARK
PVMT. PAVEMENT
F.B. FIELD BOOK
M.H. MANHOLE
A) ACTUAL
I.D. IDENTIFICATION
FND FOUND
EDP - EDGE OF PAVEMENT
Certified Correct To:
Linton Enterprises Inc.
13Z l 5416ppiuc)
4tV 1'uUC
3Nk- k-7 - 26 4 Z.
7. NO UNDERGROUND UTILITIES, FOUNDATIONS OR IMPROVEMENTS, IF ANY,
HAVE BEEN LOCATED EXCEPT AS SHOWN.
Surveyors Certification:
8. THIS BOUNDARY SURVEY MEETS OR EXCEEDS THE HORIZONTAL CONTROL
ACCURACY OF 1/7500 BEING A SUBURBAN SURVEY. I hereby certify that the attached "Boundary Survey" of the
9. ELEVATIONS BASED ON SEMINOLE COUNTY DATUM AS FOLLOWS: hereon —described property is true and Corr ct. to the best of my
knowledge, information and belief o;a rder vary direction in the
field on Janurary 9, 2018. 1 further c r if,- Qt; tnis' "Boundary
a.) Designation#: 3297401 BEING A PK NAIL & SEM CO DISK STAMPED r
329-74-01 AT THE S. E. COR. OF A CONC. WALKWAY ON PROP. OF SMOKERS Survey" meets the Standards oi`,.Pr ' i e s se, f6rth',;n chapter
EXPRESS STORE; UNDER THE OVERHANG;+/-112' W. OF THE CA OF US 17/92, 5J-17 of the Florida Admihistrativ o e.
54' N. OF CA 20TH ST. ELEVATION = 52.24
Date:' , 09 18
nror VAuv rnHoUr s r2 W. C. tt,- :S.M.
Project No. 260—LEI-007 Profession 1 rveyor ar.d_ Mapper
Dwg file: 260—LEI-007
Florida Registration No. 5599
DRAWN: WCE Boundary Survey
Linton Enterprises Inc.
1321 Shepard Avenue
Section 36, Township 19 South, Range 3o East
City of Sanford, Seminole County, Florida
KLE Surveying
Mapping, Inc.
SHEET
OF 2
APPROVED: WCE
DATE: 09/19/17 121 Burns Avenue Longwood, FL 32750
407) 402-2331
License Business # 7899SCALE: N/A
NOT VALID WTHOUT SHEET 1
n
0
0W
Z
0
W <
0
O i<
cru-< . 00-
r
M
FOUND V' 4J
IRON PIPE
Q
x M
NO ID M 0- Li
4 CHAIN LINK L0
FENCE NLi
0.2N & 3.0' W) 0
TA
Q) P.
B. J 0-
o'i-";' SET b
I IRON ROD SET 0
I'
N0
4 &CAP 100(P) IRON ROD D' 1
L13 # 7899 CAP 89018"
Z40 E 101 .75' (M) & NLB # 7899 0
A t 7" GATE <,,
cON6RETE-,', A Z0TER
DRIVE N <
1101' Ow IN"", 33.
21.
1' UTILITY
42.9 4
a + FOUND
29.
3' Q 200C (L
IRONRODC*4 STORYNO
ID K CONCRETECONCRETEBLOCk!
4' 12.1 GATE
RESIDENCE A/
C F. F. = 33.1 '0 C4 n'
PAD ATER
0 COVEREDTILED
PORCH 1 .6' L, U, bETER + (D 0 o
0 + 30.8 SET
TILED y + SET 5/W' 3'
CHAIN z C) PATIO *j ZIRONRODIRON ROD 3' CHAIN CAP
LINK FENCE LINK
FENCE 10 " &
CAP ry (
2 36' S) 37' (
S) & 1.20' W) LB # 71399 -(o LE3 # 71399 101.
98' (M FOUND
100. (
P IRON
ROD• CL
N 89 (2) WOOD AITAR NO
ID SEWER UTILITY MANHOL
it POLES qj0AENE0PDZ
CI* SET 0 . L6 to
IRONRODC-4 CAPLB #
7899 TOP
OF DISC BANK
LE
A
VENUE CONCRETE Z LB # 7899 TOP
01 BANK FLUME STORM 25'
PUBLIC RIGHT—OF—WAY VACATED PER DESCRI P 12" PLACTIC 11 - INLET LPAVED
ROAD DITCHPIPEIN-V = 24.79 1
Project
No. 260—LEI-007 Dwg
file: 260—LEI-007 DRAWN:
WCE Boundary Survey KLE Surveying SHEET APPROVED:
WCE Linton Enterprises Inc. & Mapping, Inc. DATE:
01/09/17 1321 Shepard Avenue 121 Burns Avenue Longwood, FL 32750 2 Section
36, Township 19 South, Range 3o East (407) 402-2331 OF 2 0
SCALE: 1" = 30' City of Sanford, Seminole County, Florida License Business # 7899 —
U.S' DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
Linton Enterprises Inc.
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No.
1321 Shepherd Avenue
City State ZIP Code
Sanford Florida 32771
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 35 & N 1/2 OF VACD ST ON S BILK G A D CHAPPELLS SUBD PB 1 PG 71, parcel I.D. 36-19-30-515-OG00-0350
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat.28degrees47'59" Long.-81degreesl6'45" Horizontal Datum: NAD 1927 x 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 1 B
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) N/A sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in AB.b N/A sq in
d) Engineered flood openings? Yes x No
A9. For a building with an attached garage:
a). Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? Yes x 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 Florida
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) Zone AO, use Base Flood Depth)
Revised Date
112117C0070 F 09-28-2007 02-19-2014 A 31.05
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69:
FIS Profile FIRM x Community Determined Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: NGVD 1929 x NAVD 1988 Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes x No
Designation Date: CBRS OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
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:
1321 Shepherd Avenue
City State ZIP Code Company NAIC Number
Sanford Florida 32771
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: Construction Drawings" Building Under Construction" x 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, AR/A, AR/AE, AR/A1—A30, AR/AH, 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: Seminole County # 3297401 Vertical Datum: 52.24
Indicate elevation datum used for the elevations in items a) through h) below.
NGVD 1929 x 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) 33.10 x feet meters
b) Top of the next higher floor N/A 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 33.10 x feet metersDescribetypeofequipmentandlocationinComments)
f) Lowest adjacent (finished) grade next to building (LAG) 30.30 x feet meters
g) Highest adjacent (finished) grade next to building (HAG) 31.30 x feet meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 30.71 feet metersstructuralsupport
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. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? Z Yes No Check here if attachments.
Certifier's Name License Number
WILLIAM C ELLIOTT PSM 5599
Title
PRESIDENT
Company Name
KLE SURVEYING AND MAPPING INC. v
I Vki
Address
239 WASHINGTON AVENUE
City State ZIP Code
LAKE MARY Florida 32746
Signature Date Telephone Ext.
01-09-2018 (407) 402-2331
Copy all pages of this Elevation C ifi ate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
USED GPS FOR LAT AND LONG LOCATION AND LEVEL FOR ELEVATIONS.
base flood elevation is 30 @ 1929 datum converted to 31.05 @ 1988 per Vertcon
C2 h is the elevation of the front porch and patio.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. rural raye c U! 0