1209 W Plaza CO 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
C E R T I F I C A T E 0 F 0 C C U P A N C Y
P E R M A N E N T
Issue Date . . . . . . 12/11/13
Parcel Number . . . . . 171026-0900- -
Property Address . . . 1209 W PLAZA
ATLANTIC BEACH FL 32233
Subdivision Name . . .
Legal Description
Property Zoning . . . . TO BE UPDATED
Owner . . . . . . . . . VONN BRIAN S & CHERYL F
Contractor . . . . . . E & R ENTERPRISES OF NORTH FL
904 270-2185
Application number 13-00002622 000 000
Description of Work SINGLE FAMILY RESIDENCE
Construction type . TYPE 5-B
Occupancy type . . . . RESIDENTIAL
Flood Zone . . . . . . ZONE AE
Approved . . . . . . .
Buildiiegvof f icial
VOID UNLESS SIGNED BY BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
CERTIFICATE OF OCCUPANCY WORKSHEET
Date Requested:
Contractor Name: r7;71 i Z: IS
Permit #: 2 & ,ZZ
Property Address: 12 0 7'lkzA--
Legal Description:
Improvements to the above-described property have been completed in
accordance with the terms of the permit and are certified to be ready for
occupancy as: �<e-Faniily Residence
F-1 Commercial
F-1 Other:
Lowest Floor Elevation:
Required As Built FFE
Thefollowing must be completed before issuing Certificate of Occupancy:
Department Date Notified Date Approved Approved By
Fira-PePT.- la,6 ?f4
Public Works Awtl
Public Utilities
Building
Planning
Tree Mitigation
Satisfied
L A
Final Survey with FFE Yes No
All Re-Inspect Fees Paid Yes No
Termite Treatment Yes No
Graham Shirley
From: Clemons, Malcolm
Sent: Friday, November 22, 2013 9:55 AM
To: Graham Shirley
Cc: Kaluzniak, Donna-, Walker, Jennifer
Subject: RE: 1209 W Plaza 13-2622
Backflow Inspection OK Malcolm
From: Graham Shirley
Sent: Wednesday, November 20, 2013 11:24 AM
To: Carper, Rick; Nodine, Phil; Daniels, Freddie; Clemons, Malcolm; Kaluzniak, Donna
Cc: Walker, Chris; Jones, Mike; Walker, Jennifer; Hubsch, Jeremy
Subject: 1209 W Plaza 13-2622
Ed Puttbach is requesting a CO for 1209 W Plaza Thursday 11/21, Ed can be reached at 626 5656. Please send approvals
via Email.
'Sh�rLeu clraham
Building Department
800 Seminole Rd
Atlantic Beach, Fl 32233
9042475800
sgrahamLi,coab.us
Graham Shirley
From: Walker, Jennifer
Sent: Wednesday, December 11, 2013 1:51 PM
To: Graham Shirley; Jones, Mike
Subject: 1209 W Plaza
Freddie Daniels came by here and gave me the heads up on the above, it is passed for CO.
Jev,vLU WaLlo-er
Administrative Assistant
Building Department
City of Atlantic Beach
904-247-5826
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVAT!ON GERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
Aralional Flood Insurance Program Expiration Date: July 31, 2015
Important: Read the instructions on pages I —
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name BRIAN S.VONN Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FL ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 4,5&6,BLOCK 210,ATLANTIC BEACH SECTION H,AS RECORDED IN PLAT BOOK 18,PAGE 34,DUVAL CO
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude:Lat.N30*1 9'58" Long.W81*25'33" Horizontal Datum: E] NAD 1927 ER NAD 1983
A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance.
AT Building Diagram Number N/A
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) N/A sq It a) Square footage of attached garage N/A 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 N/A within 1.0 foot above adjacent grade NIA
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? El Yes 2 No d) Engineered flood openings? El Yes 0 No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
3 State
L I
Bl.NFIP ommunity Name&Community Number B2.County Name B3.State
DUVAL CO(ALL JURISDICTIONS),12031C I DUVAL FLORIDA
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
0408 H 06/03/2013 Effective/Revised Date Zone(s) AO,use base flood depth)
Q6/03/2Ql 3 AE QFE 5'
1 .-I
B 10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
El FIS Profile Z FIRM n Community Determined n Other/Source:
BI 1. Indicate elevation datum used for BFE in Item B9: E] NGVD 1929 M NAVD 1988 El Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? El Yes El No
Designation Date: [I CBRS El OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: El Construction Drawings* 0 Building Under Construction* El 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,Vl-V30,V(with 13FE),AR,AR/A,AR/AE,AR/Al-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:NAIL IN OAK TREE(4.01) Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. El NGVD 1929 S 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 bf dom floor(including basement,crawlspace,or enclosure floor) 6.86 E feet El meters
b)Top of I ie next higher floor 17.96 0 feet El meters
c) Bottom of the lowest horizontal structural member(V Zones only) N.A Ej feet 0 meters
d)Attached garage(top of slab) N.A 0 feet El meters
e) Lowe4t elevation of machinery or equipment servicing the building N.A El feet meters
(Describe type of equipment and location in Comments)
0 Loweut adjacent(finished)grade next to building(LAG) 5.46 feet El meters
g)Highest adjacent(finished)grade next to building(HAG) 6.56 feet [I meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support N�A El feet El 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 may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
El Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
El Check here if attachments. licensed land surveyor? Z Yes El No
Certifier's Name H.Bruce Durden Jr. License Number P.L.S.#4707
Title President Company-Name Durden Surveying and Mapping,Inc.
Addres `2 B et North i Ja fonville Beach State FL ZIP Code 32250
Signatur ate /11/2013 Telephone 904.853.6822 L
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions.
F-LEVATIUN CERTIFICATE, page 2
IMPORTANT: In these spaces, copy the corresponding itiformation 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:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FIL ZIP Code 32233 Company NAIC 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 TO CONVERT ELEVATIONS TO N.G.V.D.OF 1929 YOU MUST ADD 1.09 TO ELEVATIONS SHOWN HEREON
Signature '160t&T- Date 07/11/2013
SECTION E-BUILDING ELEVATLIONINFORM' ON (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 [I feet D meters 0 above or 0 below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is El feet D meters El above or El 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 _._ E]feet E]meters El above or E]below the HAG.
E3. Attached garage(top of slab)is - . El feet El meters El above or EJ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _._ El feet E]meters E]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? El Yes El No E] 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
F-1 Check here if attachments.
SECTION G-COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the communitys 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-G1 0.In Puerto Pico only,enter meters.
G1.El 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,F1 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.E] The following information(items G4-G 10)is provided for community floodplain management purposes.
umber
G4.Permit
G7. This permit has )een issued for: El New Construction n Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: F1 feet El meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: El feet 0 meters Datum
G10,Community's design flood elevation: El feet E]meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
El Check here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
Afaiional Flood In5urance 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 BRIAN S.VONN Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FL ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 4,5&6,BLOCK 210,ATLANTIC BEACH SECTION H,AS RECORDED IN PLAT BOOK 18,PAGE 34,DUVAL CO
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude:Lat.N30'19'58 Long.W81'25'33" Horizontal Datum: 0 NAD 1927 M NAD 1983
A& Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 7
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) N/A sq ft a) Square footage of attached garage 1024 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 N/A within 1.0 foot above adjacent grade 3
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 955 sq in
d) Engineered flood openings? E] Yes Z No d) Engineered flood openings? Yes ED No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
Bl.NFIP Community Name&Community Number B2.County Name B3.State
DUVAL 0(ALL JURISDICTIONS),120077 DUVAL FLORIDA
B4.Met /Panel Number B5.Suffix = B9 Base Flood Elevation(s)(Zone
B6.FIRM Inde Date B7.FIRM Panel B8.Flood
12031 C 0408 H 06/03/2011�3 FEffective/Revised Date Zone(s) AO,use base flood depth)
06/03/2013 AE 5
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
F FIS Profile 0 FIRM F Community Determined El Other/Source:
Bl 1. Indicate elevation datum used for BFE in Item B9: [_1 NGVD 1929 El NAVID 1988 F1 Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? El Yes No
Designation Date: El CBRS [I OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: 7 Construction Drawings* El 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,Vl-V30,V(with BFE),AR,AR/A,AR/AE,AR/Al-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:NAIL IN OAK TREE(4.01) Vertical Datum: NAVID 1988
Indicate elevation datum used for the elevations in items a)through h)below. El NGVD 1929 0 NAVID 1988 El 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) 6.86 feet 0 meters
b)Top of the next higher floor 17.96 feet meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/.A feet meters
d)Attached garage(top of slab) 6.86 feet meters
e) Lowest elevation of machinery or equipment servicing the building 8.34 feet El meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent(finished)grade next to building(LAG) 6.3 0 feet El meters
g) Highest adjacent(finished)grade next to building(HAG) 6.5 Z feet D meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support El feet El 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.i certify that the information on this Certificate represents my best efforts to interpret the data available.
understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
E] Check here if attachments. licensed land surveyor? 0 Yes El No
Certifier's Name H.BRUCE DURDEN Jr. License Number P.L.S.#4707
Tide PRESIDENT le-) Company NaTe DURDEN SURVEYING AND MAPPING,INC.
Address 1 -B S NORTH city if KS#1VILLE BEACH State FL ZIP Code 32250 -
Signature -853-6822
#YJOIAO13 Telephone 904
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,andlor Bldg.No.)or P.O.Route and Box No. Policy Number:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FL ZIP Code 32233 Company NAIC 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 SECTION A7)-ENTIRE FIR5i FLOOR IS GARAGE SPACE,LIVING AREA IS ON SECOND FLOOR;SECTION A9d)-CONTRACTOR TO
SUPPLY DOC TA SEC 0 ME SHOWN IS AIR CONDITIONING UNIT.WATER HEATER(LOCATED IN GARAGE)
ELEVATIO 8.
Signature Date 12/06/2013
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 El-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 E]feet F] meters D above or E]below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is El feet EJ meters El above or 0 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 _._ [I feet [:]meters E]above or E]below the HAG.
E3. Attached garage(top of slab)is _._ El feet El meters 0 above or D below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is —.— F1 feet D meters []above or 0 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 E] No 0 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.El 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.F� A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3.7 The following information(Items G4-G10)is provided for community floodplain management purposes.
G4.Perm t Number G5. Date Permit Issued
G7. This permit has been issued for: F-1 New Construction F� Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: El feet 0 meters Datum —
G9. BFE or(in Zone AO)depth of flooding at the building site: EJ feet El meters Datum —
G 10.Community's design flood elevation: El feet El meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
F� 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:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FIL 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.
FRONT VIEW- 12/6/2013
t
LEFT VIEW- 12/6/2013 VIEW OF FLOOD VENT AND A/C UNIT
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
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:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FL ZIP Code 32233 Company NAIC Number:
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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.
REAR VIEW- 12/6/2013
RIGHT VIEW- 12/6/2013
A
FEMA Form 086-0-33(7/12) Replaces all previous editions.
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MAMGEMENT AGENCY OMB No. 166G-0008
Mational Flood Insurance Program Important: Read the instnuctions on pages 1-9. Expiration Date: July 31, 2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owners Name BRIAN S.VONN Policy Number:
A2. Building Street Address Cincluding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FL ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 4,5&6,BLOCK 210,ATLANTIC BEACH SECTION H,AS RECORDED IN PLAT BOOK 18,PAGE 34,DUVAL CO
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longftude:Lat.N30ol9'58 Long.W81*25'33" Horizontal Datum: E] NAD 1927 E NAD 1983
A6. Attach at least 2 photographs of the building if the CeTtificate is being used to obtain flood insurance.
A7. Building Diagram Number 7
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) N/A sq ft a) Square footage of attached garage 1024 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 N/A within 1.0 foot above adjacent grade 3
c) Total net area of flood openings in A8.b NIA sq in c) Total net area of flood openings in A9.b 955 sq in
d) Engineered flood openings? El Yes 0 No d) Engineered flood openings? Yes E No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
Bl.NFIP Community Name&Community Number B2,.County Name 83.State
DUVAL CO(ALL JURISDICTIONS),120077 FDUVAL FLORIDA
B4.Map/Panel Number B5.Suffix I B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12031 C 0408 H 06/0312013 Effective/Revised Date Zone(s) AO,use base flood depth)
06/03/2013 AE 5
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
FI FIS Profile E FIRM 71 Community Determined El Other/Source:-
Bl 1. Indicate elevation datum used for BFE in Item 139: 0 NGVD 1929 Z NAVD 1988 El Other/Source:
1312. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? El Yes No
Designation Date: 0 CBRS 171 OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: 0 Construction Drawings* D Building Under Construction* Z 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,Vl-V30,V(with BFE),AR,AR/A,AR/AE,ARlAl-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item AT In Puerto Rico only,enter meters.
Benchmark Utilized:NAIL IN OAK TREE(4.01) Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. 11 NGVID 1929 121 NAVD 1988 11 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) 6.86 E feet 0 meters
b)Top of the next higher floor 17.96 Z feet El meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/.A ED feet El meters
d)Attached garage(top of slab) 6.86 E feet El meters
e) Lowest elevation of machinery or equipment servicing the building 8.34 0 feet El meters
(Describe type of equipment and location in Comments)
f)l Lowest adjacent(finished)grade next to building(LAG) 6.3 Z feet meters
g) Highest adjacent(finished)grade next to building(HAG) 6.5 Z feet meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support -.- El feet El 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 may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
171 Check here if attachments. licensed land surveyor? E Yes [:1 No
Certifier's Name H.BRUCE DURDEN Jr. License Number P.L.S.#4707
Title PRESIDENT Com�an Na'e DURDEN SURVEYING AND MAPPING,INC.
y '
Ity -ACH State FL ZIP Code 32250
Address 11je-B C_ J KS1 VILLE B -
'/S NORTH
Signature 12-10112013 Telephone 904-853-6822
t 91
'.�- I vadw
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:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FL ZIP Code 32233 Company NAIC 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 SECTION A7)-ENT'RE FI�SVLOOR IS GARAGE SPACE,LIVING AREA IS ON SECOND FLOOR;SECTION A9d)-CONTRACTOR TO
SUPPLY DOC TA SECTIO EQUIPMEir SHOWN IS AIR CONDITIONING UNIT.WATER HEATER(LOCATED IN GARAGE)
8..
ELEVATIO
Signature Date 12/0612013
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 EI-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 elevaton is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG). -1 feet 0 meters El above or F-1 below the HAG.
a)Top of bottom floor(including basement,crawlspace,or enclosure)is E
b)Top of bottom floor(including basement,crawlspaGe,or enclosure)is feet El meters El 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 _._ El feet [] meters above or 0 below the HAG.
E3. Attached garage(top of slab)is _._ 0 feet El meters El above or below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _.— El feet [:1 meters El above or E]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? D Yes [I No D 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
F1 Check here if attachments.
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the communitys 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-G 10.In Puerto Rico only,enter meters.
G1.F� 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.F� 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.F1 The following information(items G4-G 10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued
G7. This permit has )een issued for: [_1 New Construction F-1 Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: El feet El meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: EI feet 0 meters Datum
G10.Community's design flood elevation: 0 feet 0 meters Datum
Local Official's Name Tide
Community Name Telephone
Signature Date
Comments
F�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,andlor Bldg.No.)or P.O.Route and Box No. Policy Number:
1209 PLAZA STREET WEST
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.
FRONT VIEW- 12/6/2013
..........I'-
LEFT VIEW- 12/6/2013 VIEW OF FLOOD VENT AND,A/C UNIT
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
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:
1209 PLAZA STREET WEST
City ATLANTIC BEACH State FIL ZIP Code 32233 Company NAIC Number:
L
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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.
REAR VIEW- 12/6/2013
RIGHT VIEW- 12/6/2013
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
Graham Shirley--
From: Walker, Chris
Sent: Thursday, December 12, 2013 12:00 PM
To: Graham Shirley
Subject: RE: 1209 W Plaza
No water and sewer av;;ilable in this area so nothing for us to inspect.
From: Graham Shirley
Sent: Thursday, December 12, 2013 9:38 AM
To: Walker, Chris
Subject: 1209 W Plaza
Did you guys go out there for the CO approval...I don't have an email from ya
sh�rLeu CIV,611,16(m
Building Department
800 Seminole Rd
Atlantic Beach, Fl 32233
9042475800
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