The URL can be used to link to this page

1086 Jasmine Street ELEVATION 08.02.2010 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 G...:-....RA.....L.94 '11147 reaeral tmergency management/agency I „ National Flood Insurance Program Important: Read the instructions on pages 1-9. Al. Building SECTION A-PROPERTY INFORMATION For Insurance cornpsrtyUse: BOTTOM Name M LINE VENTURES INC Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAINu L mber 1086 JASMINE STREET City JACKSONVILLE State FLORIDA ZIP Code 32233 f]!zz!-. c1c LOT 2, BLOCK 179 & LOT 2, BLOCK 180, ATLANTIC BEACH SECTION H, PLAT BOOK 18, PAGE 34. A4, Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. Long. Horizontal Datum: []NAD 1927 NAD 1983 A6. Attach at least 2 ohotooraohs of the building_ if the Certificate is beino used to obtain flood insurance. A7. Building Diagram Number 1 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) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage 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 1 04 Kin 120075 ATLANTIC BEACH I DUVAL I v -- FLORIDA , B4.Map/Panel Number B5.Suffix B6.F�ndeI7, RM Panel 68.Flood B9.Base Flood Elevation(s)(ZonRevised Date ZAE(s) AO,use base flood depth) 0001 D 04— 5.00 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. FIS Profile ®FIRM Community Determined Other(Describe) 811. Indicate elevation datum used for BFE in Item 89: ®NGVD 1929 ❑NAVD 1988 ❑Other(Describe) 812. Is the building located in a Coastal Barrier Resources System S)(CBRarea or Otherwise Protected Area(OPA)? F-1Yes ® No DGt'tylidii"i Dtlic r�lioRO Cl vrm u u SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑Construction Drawings- Building Under Construction- ❑ Finished Construction cz.t;f. t;: :11 tc .. ..V...L.. ..i:.. v a4.,v..:ly:.... ..1..,.. C2. Elevations-Zones Ai-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. Use the same datum as the BFE. Benchmark Utilized CITY BENCH MARK Vertical Datum NGVD 1929 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 8.00 El feet meters(Puerto Rico only) b) Top of the next higher floe N/A feet LJ meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N A _Q feet ❑meters(Puerto Rico only) d; A11n..1..-s.l .... �..y rC., ;1 . .i-�.. ; N A n_F e) Lowest elevation of machine orequipment servicin the building N A u machinery9 9 .�_•�feet �meters(Puerto Rico only) (Describe type of equipment and location in Comments) f1 Lowest adjacent(finished)grade next to building(LAG) 5, 40fK feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.80 X feet meters(Puerto Rico only) n) Lowest aojacem graoe at iowest eievauon Of(JecK or stairs,incivamg N A ._U Tee[ U meters trueno Kico only) structural support 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. f certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any raise statement may be punisnadte by line or imprisonment under 76 u.s.Gocie,section t UU1. Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? [ Yes ❑No T,, Certifier's Name License Number ANTHONY PAUL O'NOL PSM 5684 Title Company Name SURVEYOR ROONEY do SONS Address City State ZIP Code _ 5545 SHANNON AVENUE JACKSONVILLE FLORIDA 32254 Signature Date Telephone 08-02-10 904-379-2574 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. Fob insurance tbmpeny Use:e Building Street Address('including Apt., Unit, Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy NU-abIor City State ZIP Code Company MAIC NuInbor SFCTIAN D.SIIRVFYOR FNGINFFR OR ARCHITFCT CFRTIFICATION fCONTINUFDI Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Signature Date ❑ Check here if attachments 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,8, 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 and I. Iw...nM n.linwnn/n-n.dn!1 AP'•\ a)Top of bottom floor(including basement,crawispace,or enclosure)is__„_, []feet ❑meters ❑above or below the HAG, b)Top oibcdom floor(including basement,crawlspece,or enclosure)Is ` Meet ❑meters []above or below the LAO. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(sec pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _ _❑feet ❑meters ❑above or LJ 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 owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or communiwssued 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 ANTHONY PAUL O'NEIL Aaaress uty Slate LIN uoae 5545 SHANNON AVENUE JAMMULLE FLORIDA 32254 Signature r1 � Date 08-02-10 Telephone 904-379-2574 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 and G9. 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. r❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community issued BFE)or Zone AO. I i ThP frJtnwinrt infnrmatinn/(fames r_dr_a�iG MMnrIPA fnr r�MM11nR\/Bn/+r7nlaln MOn anPMPnf mlmncoc i G4.—Permit"Nurnber t38. 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(PR) Datum G9. BFE or(in Zone AO)depth of flooding at the building site ❑feet ❑meters(PR) Datum G10.Community's design flood elevation ❑feet ❑meters(PR) Datum Locat 9*38A'!!�IVx�,nor Title Community Name Telephone SCgrr3tu!e Date Cammsr:t's ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions