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04-3039
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04-3039
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Last modified
3/6/2009 3:24:43 PM
Creation date
1/25/2007 3:22:28 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
04-3039
Building Department - Name
BACMAR PTOP.
Address
4915 5TH ST
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<br />FEDERAL EMERGENCY MANAGEMENT AGENCY <br />NATIONAL FLOOD INSURANCE PROGRAM <br /> <br />.4 <br /> <br />ELEVATION CERTIFICATE <br /> <br />O.M.B. No. 3067-0077 <br />Expires December 31, 200e <br /> <br />1m rtant: Read the instructions on es 1 .7. <br />SECTION A. PROPERTY OWNER INFORMATION <br /> <br />For IIISlJIaIlre CoIll>any Use: <br />Policy Number <br /> <br />BUILDING OWNER'S NAME <br />ALVIN BACHTEL CONSTRUCTION <br />BUILDING STREET ADDRESS (In luding Apt., U . ,S " or Bldg. No.) OR P.O. ROUTE AND BOX NO. <br />5th STREET <br />CITY STATE <br />ZEPHRYHILLS FL <br />PROPERTY DESCRIPTION (lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) <br />Lot 7, Block 11, MOORES ADDITION, P.B. 1, PG. 57 <br />BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) <br />Residential <br />LATITUDE/LONGITUDE (OPTIONAL) <br />( ##0 _ ##' _ ##.##" or ##.#####') <br /> <br /> <br />Company NAlC 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 />83. STATE <br />FL <br /> <br />84. MAP AND PANEL 87. FIRM PANEL B9. BASE FLOOD ELEVATlON(S) <br />NUMBER 85. SUFFIX 86. FIRM INDEX DATE EFFECTlVEiREVlSED DATE 88. FLOOD ZONE(S) (ZoneAO, usedepthofftoodilg) <br />0005 C 12117/91 12117/91 AE 84.0' <br /> <br />810. Indicate the source of the Base Rood Bevation (8FE) data or base flood depth entered in 89. <br />o FIS Profile 181 FIRM 0 Community Determined 0 Other (Desaibe): _ <br />811. Indicate the elevation datum used for the 8FE in 89: 181 NGVD 1929 0 NAVD 1988 0 Other(Desaibe):_ <br />812. Is the building located in a Coastal Barrier Resources System (C8RS) area ar OtherNise Protected Area (OPA)? 0 Yes 181 No Designation DateNA <br />SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br /> <br />C1. Building elevations are based on: 181 Construction Drawings" 0 Building Under Construction" 0 Rnished Construclion <br />"A new Bevation Certificate will be required when construction of the building is complete. <br />C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 arld 7. If no diagram <br />accurately represents the building, provide a sketch ar photograph.) <br />C3. Bevations - Zones A l-A30, AE, AH, A (with 8FE), VE, Vl-V30, V (with 8FE), AR, ARJA, ARJAE, ARJA l-A30, ARJAH, ARJAO <br />Complete Items C3.-a-l below occording to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used far the 8FE in <br />Section 8, convert the datum to that used for the 8FE. ShaN field measurements and datum conversion calculation. Use the space provided or the Comments area of <br />Section D or Section G, as appropriate, to document the datum conversion. <br />Datum NGVD 1929 Conversion/Comments NA <br />Elevation reference marl< used Local Does the elevation reference mark used appear on the FIRM? 0 Yes C8J No <br />o a) Top of bottoo1 floor (including basement or endosure) NA. _ft.(m) <br />o b)Topofnexthigherfloor NA._ft.(m) <br />o c) Bottom of la.vest horizontal structural member (V zones only) NA . _ft.(m) <br />o d) Attached garage (top of slab) NA. _ft.(m) <br />o e) lDNest elevation of machinery arldIar equipment <br />5elVidng the building (Desaibe in a Comments aea) <br />o ~ Lowest OOjacent (finished) gra:1e (lAG) <br />o g) Highest oojacent (finished) gra:1e (HAG) <br />o h) No. of permanent openings (flood vents) within 1 ft. above oojacent grade NA <br />o i) Total area ofa/I permanent openings (flood vents) in C3.hMsq. in. (sq. an) <br /> <br />SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION <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. Smitrl UCENSE NUMBER 5265 <br /> <br />'iU <br />Q) <br />(/) <br />" <br />Q)Q) <br />liP; <br />00 <br />.0" <br />Eco <br />Wtll <br /> <br />Il,~~ / <br />~~ V' <br />,-t~ <br />r ,\\1\ ok <br /> <br />NA._ft.(m) <br />80 . !i,ft.(m) <br />M.~ft.(m)m <br />..: OJ~ <br />Q)~ <br />.0::> <br />Eiii <br />::>co <br />Z.!2' <br />"'(/) <br />(I) <br />co <br />'" <br />u <br />:::; <br /> <br />TITLEProfessional Surveyor and Mapper <br /> <br />COMPANY NAME David L. Smith Surveying and Mapping <br /> <br />ADDRESS <br />1406 W. Unsbaugh Ave. <br />SIGNA;? --t I--;J .--:-- <br /> <br />CITY <br />Tampa <br />D~TE <br />sl1/7 ()4 <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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