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04-3038
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04-3038
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Last modified
3/6/2009 3:24:44 PM
Creation date
1/25/2007 3:21:39 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
04-3038
Building Department - Name
BACMAR PTOP.
Address
4923 5TH ST
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<br />FEDERAL EMERGENCY MANAGEMENT AGENCY <br />NATIONAL FLOOD INSURANCE PROGRAM <br /> <br />a.M.B. No. 3067-0077 <br />Expires December 31, 200E <br /> <br />ELEVATION CERTIFICATE <br /> <br />Important: Read the insbuctions on pa es 1 . 7. <br />SECTION A - PROPERTY OWNER INFORMATION <br /> <br />For Insuranre Company Use: <br />Policy Number <br /> <br />BUILDING OWNER'S NAME <br />ALVIN BACHTEL CONSTRUCTION <br />BUILDING STREET ADDRESS Jlncluding p.pf Unit,.Syite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. <br />5th STREET ..a. l" -4: (..o;'~ <br />CITY STATE <br />ZEPHRYHILLS FL <br />PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) <br />Lot 6, Block 11, MOORES ADDmON, P.B. 1, PG. '5l <br />BUILDING USE (e.g., Residential, Non-residenlial, Addition, Aa:essory, etc. Use a Comments area, if necessary.) <br />Residential . <br />LATITUDE/LONGITUDE (OPTlONAW <br />( ##0. ##' . ##.##" or ##.#####) <br /> <br />Company NAIC Number <br /> <br />ZIP CODE <br />33541 <br /> <br />HORIZONTAL DATUM: <br />o NAD 1927 0 NAD 1983 <br /> <br />SOURCE: 0 GPS (Type):- <br />o USGS Quad Map <br /> <br />o Other:_ <br /> <br />SECTION B . FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br /> <br />B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER <br />CITY OF ZEPHRYHILLS 120235 <br /> <br />82. COUNTY NAME <br />PASCO <br /> <br />B3.STATE <br />FL <br /> <br />B4. M6.P AND PANEL B7. FIRM PANEL I B9. BASE FLOOD ELEVATION(S) <br />NUMBER 85. SUFRX 86. ARM INDEX DATE EFFECTlVElREVlSED DATE 88. FLOO~ZONE(S) I (Zone AD, use depth of lkJoding) <br />0005 C 1211781 1211781 84.0' <br /> <br />B10. Indicate the source of the Base Rood Bevation (BFE) data or base flood depth entered in B9. <br />o FIS Profile (gj FIRM 0 Community DeIennined 0 Other (Describe): _ <br />B11. tndicatetheelevation datum used for the BFE in B9: (gj NGVD 1929 0 NAVD 1988 0 Other(Describe):_ <br />B12. Is the building located in a CoastaJ Barier Resources System (CBRS) <rea or Otherwise Protected Area (OPA)? 0 Yes (gj No Designation DateNA <br />SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br /> <br />C1. Building elevations are based on: t8] Constructioo Drawings- 0 Building Under Construction* 0 Rnished Construction <br />* A new Bevation Certificate will be required when CXlIlstructioo of the building is complete. <br />C2. Building Diagram Number 1 (Select the building diagram most similar to the building forwhich this certificate is being completed - see pages 6 and 7. If no diagram <br />accurately represents the building, provide a sketch or photograph.) <br />C3. Bevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, APJA, ARJAE, ARJA 1-A30, ARJAH, ARJAO <br />Complete Items C3.-a-i belO\1V according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in <br />Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of <br />Section 0 or Section G, as appropriate, to document the datum conversion. <br />Datum NGVD 1929 Conversion/Comments NA <br />Bevation reference mark used Local Does the elevation reference mark used appear on the FIRM? 0 Yes [8] No <br />o a) Top of bottom floor (induding basement or endosure) NA. _ ft.(m) <br />o b) Top of next higher floor NA._ft.(m) <br />o c) Bottom of lowest horizontal structural member 01 zones only) NA . _ft.(m) <br />o d) Attached garage (top of slab) NA. _ft.(m) <br />o e) l..c7Nest elevatioo of machinery and/or equq:xnent <br />servicing the building (Desaibe in a Comments area) <br />o f) Lowest adja::ent (finished) grcde (LAG) <br />o g) Highest adjacent (finished) grcde (HAG) <br />o h) No. of permanent openings (flood vents) within 1 ft. above adjacen1 grade NA <br />o i) T olal area of all permanent openings (flood vents) in C3.h ~sq. in. (sq. an) <br /> <br />SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <br /> <br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. <br />I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. <br />I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. <br />CERTIFIER'S NAME David L Smith UCENSE NUMBER 5265 <br /> <br />NA._ft.(m) <br />82.Q.ft.(m) <br />~. Q.ft.(m) <br /> <br />":w <br />CD~ <br />.c:::l <br />Em <br />:::lC <br />zE <br />Olen <br />'" <br />c <br />Ol <br />() <br />:::J <br /> <br />! <br />I <br />I <br />I <br />I <br />I <br />L <br /> <br />o /' <br />~ ~ I/.;V ~.-J <br />y. <br />IJ..). \~ ~ <br />{ c.\\\\ <br />J <br /> <br />a; <br />Ol <br />en <br />'C <br />CDOl <br />"'- <br />",11l <br />00 <br />.c'C <br />Ec <br />WI1l <br /> <br />TITLEProfessianal Surveyo~ and Mapper <br /> <br />COMPANY NAME David L Smith Surveying and Mapping <br /> <br />ADOR.ESS <br />1406 W. Linebaugh Ave. <br />S!G~JATURE ,IJ ,-{ j.-- ~ -s-- <br /> <br />CITY <br />Tampa <br />OAT'" <br />5111104 <br /> <br />STATE <br />FL <br />TELEPHONE <br />813-935-1960 <br /> <br />ZIP CODE <br />33612 <br /> <br />FEMA Form 81-31, January 2003 <br /> <br />See reverse side for continuation. <br /> <br />Replaces all previous editions <br />
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