587 BEACH AVE FFE CERT AND SURVEY U.S. DEPARTMENT SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9. Expiration Date: July 31, 2015
SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name KIRK R &ANNE MARIA MOQUIN Policy Number:
A2. Build5 7 treet BEACHe ((AVENUi Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number:
City ATLANTIC BEACH State FL ZIP Code 32233
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 5&6, BLOCK 20,ATLANTIC BEACH SUBDIVISION A; PB 5, PG 69; RE#170157-0000
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. :fin° 19' 50 A" N Long. 81' 23'45-0"W Horizontal Datum: ❑NAD 1927 ❑x 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 5
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 1236 sq ft
b) Number of permanent flood openings in the crawlspace0 b) Number of permanent flood openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.10 0 sq in c) Total net area of flood openings in A9.b O sq in
d) Engineered flood openings? ❑Yes X No d) Engineered flood openings? ❑Yes X No
SECTION B—FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3. State
CITY OF ATLANTIC BEACH 120075 DUVAL FL
B4. Map/Panel Number B5.Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s)(Zone
Revised Date A0,use base flood depth)
12031CO409 H 06/03/2013 06/03/2013 X&AO AO BFD 2'
810.Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in Item B9:
❑FIS Profile X FIRM ❑Community Determined ❑Other/Source:
Bll.Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 X NAVD 1988 ❑Other/Source:
B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes X No
Designation Date: / / ❑CBRS ❑OPA
SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑Construction Drawings* ❑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,V1—V30,V(with BFE),AR,AR/A,AR/AE,AR/A1—A30,AR/AH,AR/A0. Complete Items
C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters.
Benchmark Utilized: 14.04 (COMMENT) Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ❑NGVD 1929 X 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) 17 9 X feet ❑meters
b) Top of the next higher floor 26 0 X feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑feet ❑meters
d) Attached garage(top of slab) 17 _9 X feet ❑meters
e) Lowest elevation of machinery or equipment servicing the building 18 1 X feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 14 2 X feet ❑meters
g) Highest adjacent(finished)grade next to building(HAG) 15 0 X feet ❑meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 17 2 X feet ❑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.1 certify that the information on this Certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001.
❑x 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? X Yes ❑No
CE
Certifier's Name License Number \
DONN W BOATWRI T LS 3295 O
Title Company Name f�1=�C Ol_
PRESIDENT BOATWRIGHT LAND SURVEYORS, INC.
Address City State ZIP Code
1500 ROB RTS DR E I JAX BEACH FL 32250
Signature Date Telephone v
10/12/2015 (904)241-8550
FEMA Form 086-0-33(Revised 7/12) See reverse side for continuation. 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:
587 BEACH AVENUE
City State ZIP Code Company NAIC Number:
ATLANTIC BEACH FL 32233
FRONT VIEW
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REAR VIEW
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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:
587 BEACH AVENUE
City State ZIP Code Company NAIC Number:
ATLANTIC BEACH FL 32233
RIGHT SIDE VIEW
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LEFT SIDE VIEW
FEMA Form 086-0-33(Revised 7/12) Replaces all previous editions.