1600 selva Marina Dr 2014 eleva Cert for club house pool bath fitness bldg m LETTER OF TRANSMITTAL
MAY 16 014
General Contractors, Inc.
L
248 LEVY ROAD / P.O.Box 330775
ATLANTIC BEAR FLORIDA 32233
(904) 241-4416 / FAX (904) 241-4427
COMPANY: City of Atlantic Beach ATTENTION: Shirley Graham
ADDRESS: 800 Seminole Rd. DATE: 5/16/14
CITY/STATE/ZIP: Atlantic Beach,FL 32233 REFERENCE/JOB: Atlantic Beach Country Club
PHONE: (904)247-5826 JOB#: 013119
WE ARE SENDING YOU: ® ATTACHED ❑UNDER SEPARATE COVER VIA Hand Delivery by Cat THE
FOLLOWING ITEMS:
❑SHOP DRAWINGS ❑PRINTS ❑SAMPLES ❑SPECIFICATIONS
❑COPY OF LETTER ❑CHANGE ORDER ❑ OTHER
COPIES DATE DESCRIPTION
1 5/12/14 Elevation Certificates for Club House,Pool Bath&Fitness Buildings
THESE ARE TRANSMITTED AS CHECKED BELOW:
❑ FOR APPROVAL ❑APPROVED AS SUBMITTED ❑RESUBMIT COPIES FOR APPROVAL
❑
FOR
❑ ED ❑SUBMIT_COPIES FOR DISTRIBUTION
AREQUESTED RETURNCORRECTED PRINTS
❑ FOR REVIEW AND COMMENT
Remarks:
SIGNED: Jennifer Snow
Senior Project Manager Assistant
Copy to File.
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL!EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
Notional 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 RPC General Contractors, Inc. Policy Number
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number
1600 Selva Marina Drive(Clubhouse)
City Atlantic Beach State FI ZIP Code 32233
A3. Property Description (Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
Part of Section 8,Township 2 South, Range 29 East, Duval County,Florida
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residential
A5. Latitude/Longitude: Lat.30-20-27 Long. 81-24-17 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 11-BB
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 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 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
Atlantic Beach, 120075 TDuval Florida
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)(Zone
12031C-0409 H 6-03-13 Effective/Revised Date Zone(s) AO, use base flood depth)
6-03-13 X 6.0
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/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ 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:Local Bench Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ® NAVD 1988 ❑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) 9.4 ®feet ❑meters
b)Top of the next higher floor n/a. ❑feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) n/a. ❑feet ❑meters
d)Attached garage(top of slab) n/a. ❑feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building n/a. ❑feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.2 ®feet ❑meters
g) Highest adjacent(finished)grade next to building(HAG) 9.1 ®feet ❑meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support n/a. ❑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. I 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.
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No
Certifier's Name Harold Eiland License Number LS 2518 �ifr
Title President Company Name Eiland&Associates, Inc. V6
1 I
Address 615 Blanding Boulevard City Orange Park State FI ZIP Code 32073
Signature Date 5-12-14 Telephone 904-272-1000
ry
FEMA Form 086-0-33 (7/12) See rP.vPrR9 sides fnr cnntiniiatinn
"L.a_V rn I wIN v"IN III wr%I L-, Fats a
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
E,uilding Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No, Policy Number
1600 Selva Marina Drive(Clubhouse)
City Atlantic Beach State FI 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
Longitude and Latitude shown hereon were obtained from Google Earth,
Signature Date 5-12-14
SECTION E— I DING ElLf\IATIM INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1—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.
E1. 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 ❑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 ❑ 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 FI 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: ❑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.
"FMA Fnrm r1RR-r1-33 (7/191 "
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
City State ZIP Code 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.
FEMA Form 086-0-33 (7112) 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
City State ZIP Code 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.
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
National Ffood Insurance Progranr 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 RPC General Contractors, Inc. Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No, Company NAIC Number.
1600 Selva Marina Drive(Pool-Bath)
City Atlantic Beach State FI ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Part of Section 8,Township 2 South, Range 29 East, Duval County,Florida
A4 Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residential
A5. Latitude/Longitude:Lat.30-20-28 Long.81-24-17 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 1_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 ft 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 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
Atlantic Beach, 120075 Duval Florida
B4.Map/Panel Number 85. Suffix B6.FIRM Index Date B7.FIRM Panel B8, Flood B9. Base Flood Elevation(s)(Zone
12031C-0409 H 6-03-13 Effective/Revised Date Zone(s) AO, use base flood depth)
6-03-13 X 6.0
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 ❑ 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)
C1. 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,ARAE,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 Local Bench Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ®NAVD 1988 O 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) 9.4 ®feet ❑meters
b)Top of the next higher floor n/a. ❑feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) n/a. ❑feet ❑meters
d)Attached garage(top of slab) n/a. ❑feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building n/a. ❑feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.9 ®feet ❑meters
g) Highest adjacent(finished)grade next to building(HAG) 9.3 ®feet ❑meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support n/a. ❑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.1 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. t `
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No
Certifier's Name Harold Eiland License Number LS 2518
Title President Company Name Eiland&Associates, Inc.
Address 615All
anding Boulevard City Orange Park State FI ZIP Code 32073 U� v� �\
Signature Date 5-12-14 Telephone 904-272-1000
FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
LLL V_I w.v -L.P.111 1�t-%I L, POUG L
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
1600 Selva Marina Drive(Pool-Bath)
City Atlantic Beach State FI 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
Longitude and Latitude shown hereon were obtained from Google Earth.
Signature Date 5-12-14
SECTIO B LDING E EVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1—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.
E1. 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 C2.1b in the diagrams)of the building is ❑feet ❑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 ❑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 FI 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: ❑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
City State ZIP Code 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.
10 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
City State ZIP Code 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.
1
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
National Flood/nsuronce 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 RPC General Contractors, Inc. Policy Number
A2, Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
1600 Selva Marina Drive(Workout)
City Atlantic Beach State FI ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Part of Section 8,Township 2 South,Range 29 East, Duval County,Florida
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residential
A5. Latitude/Longitude. Lat. 30-20-29 Long.81-24-17 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 11B
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 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 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
61. NFIP Community Name&Community NumberTD
ounty Name B3.State
Atlantic Beach, 120075 Florida
B4. Map/Panel Number B5,Suffix B6.FIRM Index Date B7. FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12031C-0409 H 6-03-13 Effective/Revised Date Zone(s) AO,use base flood depth)
6-03-13 X&AE 6.0
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 139: ❑ NGVD,1929 ® NAVD 1988 ❑ Other/Source:
812 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,ARIA,AR/AE,AR/A1—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:Local Bench Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑ NGVD 1929 ® NAVD 1988 O 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) 9.4 ®feet ❑meters
b)Top of the next higher floor n/a ❑feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) n/a. ❑feet ❑meters
d)Attached garage(top of slab) n/a. ❑feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building n/a. ❑feet ❑meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent(finished)grade next to building(LAG) 8.3 ®feet ❑meters
g) Highest adjacent(finished)grade next to building(HAG) 8.6 ®feet ❑meters
h) Lowest adjacent grade at lowest elevation of deck or stairs including structural support n/a. ❑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.I 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.
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No
Certifier's Name Harold Eiland License Number LS 2518 (j�I
Title President Company Name Eiland&Associates, Inc.
Address 615 BI riding Boulevard City Orange Park State FI ZIP Code 32073
Signature Date 5-12-14 Telephone 904-272-1000
`7 OWT
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions.
L"L_V 1 a wI• v"U%III wn I L-, Pau V c
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
1600 Selva Marina Drive(Workout)
City Atlantic Beach State FI 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
Longitude and Latitude shown hereon were obtained from Google Earth.
Signature Date 5-12-14
SECTION E 2EIDILDING ELEI TION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1—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.
E1. 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 ❑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 ❑ 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 FI 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: ❑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
City State ZIP Code 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.
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
City State ZIP Code 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.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.