780 Begonia Street ELEVATION 06.24.2013 U.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 GUNSAULIES,PAUL E Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number:
780 Begonia Street
City Atlantic Beach State FL ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
38-2S-29E,SEC H ATLANTIC BEACH PB 18 PG 34 LOT 4,BLK 144,APN 170927 0020
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential
A5. Latitude/Longitude:Lat.N30.19'49" Long.W81.2527 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) 0 sq ft a) Square footage of attached garage 460 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 0 within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 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
12031 DUVAL FL
B4.Map/Panel Number 85.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
0408 H 6-3-2013 Effective/Revised Date Zone(s) AO,use base flood depth)
NA AE 5.0'
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 0 Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. 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,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:FDOT NETWORK GPS Vertical Datum: 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 El NAVD 1988 0 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) 7.1 ®feet ❑ meters
b) Top of the next higher floor NA. ❑feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) NA. ❑feet ❑meters
d)Attached garage(top of slab) 6.6 ®feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building 6.5 ®feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 6.0 ®feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 6.5 ®feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 6.1 ®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./certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement maybe punishable by fine or imprisonment under 18 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 PLACE
❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No A/,Ry S' 04
s
Certifier's Name DARYL BANKS License Number 6063 o 6063 Nc 6063
Title PRESIDENT Company Name BANKS&BANKS CONSULTING S STATE OF
FC 10'
Address 83 W 9TH STREET City ATLANTIC BEACH State FL ZIP Code 32233 et10OR .'l8'
'ring
Signature DARYL BANKS Date 6-24-2013 Telephone 904.685.2800
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 Number:
780 Begonia Street
City ATLANTIC BEACH State FL ZIP Code 32233 Company NAIL 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 ELEVATION CENTERLINE OF ASPHALT ROAD(BEGONIA)5.56'.
Signature DARYL BANKS Date 6-24-2013
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 El—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.
El. 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 El 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 El 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
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: El 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. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number:
780 Begonia Street
City ATLANTIC BEACH State FL ZIP Code 32233 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.
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FEMA Form 086-0-33(7/12) Replaces all previous editions.
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