2061 Beach Avenue ELEVATION 06.27.2013 U.S.DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY ELEVATION CERTIFICATE 0 B No. 1660-0008
National Flood Insurance Program IMPORTANT:Follow the instructions on pages 1-9. LExpiration Date:July 31, 2015
SECTION A—PROPERTY INFORMATION
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Building Owner's Name RICHARD AND MIMI SHAW TRUST NO
A2.
Building Street Address�including Apt.,Unit,Suite,and/or Bldg. No.)or PO. Route and Box No. gcqMpa A[ bbo ft"
2061 BEACH A E
City ATLANTIC BEACH State ZIP Code VP I�,�Wr
FL 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 73(NORTH HALF)AND LOT 74(SOUTH HALF) NORTH ATLANTIC BEACH UNIT 3;PB15, PG 93; RE#169717-0000
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude:Lat. 10* 21'.5 4"N Long. 81' 23'53 3"W Horizontal Datum: El NAD 1927 9 NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT 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) 538 sq ft a) Square footage of attached garage 609 —sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attach
or enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade Q ed garage
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sqin
d) Engineered flood openings? El Yes X No d) Engineered flood openings? El Yes XNo
SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
Bl. NFIP Community Name&Community Number B2.County Name B3.State
CITY OF ATLANTIC BEACH 120075 DUVAL I FL
B4. Map/Panel Number 135.Suffix B .FIRM Index Date B7.FIRM Panel Effective/ 7B8. Flood Zone(s,) B9. Base Flood Elevation(s)(Zone
Revised Date AO,use base flood depth)
1202 H 06/03/2013 06/03/2013 X&AO 2'BFD
BIO.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139:
[-]FIS Profile Z FIRM EJ Community Determined El Other/Source:
Bll.Indicate elevation datum used for EFE in Item B9: El NGVD 1929 X 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 XNo
Designation Date: —/— El CBRS [:1 OPA
SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: F1 Construction Drawings* E]Building Under Construction* X 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: 22.0(COMMENI) Vertical Datum: NAVID 1988
Indicate elevation datum used for the elevations in items a)through h)below. E]NGVD 1929 JR NAVD 1988 E]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) 17 7 X feet 0 meters
b) Top of the next higher floor 28 9 X feet El meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A N feet 0 meters
d) Attached garage(top of slab) 17 2 CK feet 0 meters
e) Lowest elevation of machinery or equipment servicing the building 22 6 N feet 0 meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 17 5 Z feet El meters
g) Highest adjacent(finished)grade next to building(HAG) 22 6 N feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A — N feet EI meters
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.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.
Z Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
1-1 Check here if attachments. licensed land surveyor? El Yes :K No
ek.;
Certifier's Name License Number LA
DONN W BOATWRIGHT LS 3295
. I I L N
Title Company Name RE N, Ii-
PRESIDENT BOATWRIGHT LAND SURVEYORS, INC.
Address city State ZIP Code
,1500 RQBERT�\DIAIVE JAX BEACH FL 132250
Signature Date Telephone V]
06/27/2013 (904)241-8550 V
FEMA Form 086-0-33(Revised 7/12) See reverse side for continuation. Rp.nlqr.,-.q RII nro-vi-qm
ELEVATION CERTIFICATE,page 2
IMPORTANT:In these spaces,copy the corresponding information from Section A. COMPANY USE 777
Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or PO. Route and Box No. �,Polic0umber:.,
2061 BEACH AVE
City State ZIP Code -,,'C NAIC Number*,,.,
ATLANTIC BEACH FL 32233 . ...... .
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 A5- INFC,�kRMATION OBTAINED FROM ITOUCH MAP.COM
C-BENCHMARK 01�ATION: MN ON NORTH SIDE OF 10"PINE AT S P/L OF 2061 BEACH AVE
C2A-"LIVI GSPA E��HIND GARAGE." C213-2ND FLOOR LIVING SPACE.
C2e-LOISTAC 0 ENSER UNIT LOCATED ON CONCRETE PAD
Signature -K���
Date 06/27/2013
SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD 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 E1-114,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 4 9 X feet E]meters E]above or X below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is 0 2 N feet El meters 2 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 N/A El feet 0 meters El above or 0 below the HAG.
E3.Attached garage(top of slab)is 5 4 N feet 0 meters F1 above or X below the HAG.
E4.Top of platform of machinery and/or equipment servicing the building is 0 0 N feet El meters E]above or E below the HAG.
E5.Zone AD 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 0 No X 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 Ow 7 r or Ow t r'\Authorized Representative's Name DONN W BOATWRIGHT, PSM
Address 150 ROB T �RIVE city JAX BEACH State FIL ZIP Code 32250
Signature Date 06/28/2013 Telephone (904)226-9626
Comments
F]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-G1O.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-1 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. F� The following information(Items G4-G1O)is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
14-00000 -?2-01 1
G7. This permit has been issued for: []New Construction F-1 Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: 0 feet El meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: El feet El meters Datum
G10.Community's design flood elevation: 0 feet El meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
EJ Check here if attachments.
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 PO.Route and Box No. Policy Number:
2061 BEACH AVE Company NAIC Number:
City State ZIP Code
ATLANTIC BEACH FL 32233
RIGHT SIDE VIEW
3
LEFT SIDE VIEW
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A&L
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FEMA Form 086-0-33(Revised 7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS
See instructions for item A6. FOR INSURANCE COMPANY USE
IMPORTANT:In these spaces,copy the corresponding information from section A.
Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or PO. Route and Box No. Policy Number:
2061 BEACH AVE State ZIP Code Company NAIC Number:
City
ATLANTIC BEACH FL 32233
FRONT VIEW
REAR VIEW
AM"
Replaces all previous editions.
FEMA Form 086-0-33(Revised 7/12)