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350 3rd Street ELEVATION 12.14.2016 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company, and (3)building owner. SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Richard Schooling A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Company NAIC Number Box No. 350 Third Street City State ZIP Code ATLANTIC BEACH Florida 32233 A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) L-15&17,PT-13,ATLANTIC BEACH, PB-5, PG-69 CURRENT PUBLIC RECORDS OF DUVAL, FL A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.N30°19'39.75" Long.W81°23'54.91" Horizontal Datum: ❑ NAD 1927 0 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 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in d) Engineered flood openings? ❑Yes 0 No A9. For a building with an attached garage: a) Square footage of attached garage 345 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes 0 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 Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12031C 0409 H 06/03/2013 06/03/2013 "X" N/A B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9: ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 0 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 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2018 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: 350 Third Street City State ZIP Code Company NAIC Number ATLANTIC BEACH Florida 32233 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 A1—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: PK NAIL&DISK(8.32) 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) 10. 27 © feet ❑ meters b) Top of the next higher floor 11 26 feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑x feet ❑ meters d) Attached garage(top of slab) 11 26 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building NSA. ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished) grade next to building(LAG) N/A. 0 feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) N/A. x❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including NSA 0 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. 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. Were latitude and longitude in Section A provided by a licensed land surveyor? El Yes ❑No ❑Check here if attachments. Certifier's Name License Number H. Bruce Durden Jr. PLS 4707 Title President/Owner Company Name Place Durden Surveying&Mapping, Inc. Seal Address Here 1825-B 3rd Street North City State ZIP Code Jacksonvill- B-.ch Florida 32250 g ur- Date Telephone 12/14/2016 (904)853-6822 Copy all pages of this Elevation Certifica and all attachments for(1)community official, (2)insurance agent/company,and(3)building owner. Comments(including type of equipm t and location, per C2(e), if applicable) LATITUDE AND LONGITUDE AND ELEVATIONS OBTAINED USING SPECTRA PRECISION PROMARK 700 GPS UNIT; C2e) EQUIPMENT SERVICING BUILDING IS AN A/C UNIT: FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2018 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: 350 Third Street City State ZIP Code Company NAIC Number ATLANTIC BEACH Florida 32233 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 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. 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 ❑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 1-2 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 or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2018 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: 350 Third Street City State ZIP Code Company NAIC Number ATLANTIC BEACH Florida 32233 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(including type of equipment and location, per C2(e), if applicable) Li Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018 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: 350 Third Street City State ZIP Code Company NAIC Number ATLANTIC BEACH Florida 32233 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. < Y 'r ,1 `. i • . x " ' < --at1.-+:ter- - - ..'r4 'nab: J3' Photo One Photo One Caption FRONT VIEW +gst t t' ,; � ti .... 1,. , ,t • • -y . 1. ff: .4t .: « :� Yg �/1 .. t.p awn' 1., / . a.. iy tines r (� �lI.L�k -i ,�Ayi 77 +` .ate `4a... - ''Lm..a - .. Photo Two Photo Two Caption RIGHT SIDE FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2018 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: 350 Third Street City State ZIP Code Company NAIC Number ATLANTIC BEACH Florida 32233 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. 7 --44110;trt: • 41. , $ • .,,,.,. ._ •,,.....;;?!•-•• "1"4. •v; • .• '. .... 7' ..- .1"-•.':1, 's , ,:i. $4 Ae••a K •, l' ! '.iztt , . . rte" �' :E' IIIS .93''- 4.:111. ' 1 ,. }. . . . It b i *04y. Photo One Photo One Caption REAR VIEW 1 �e e"I3R „ Fia` _ r� • r . ♦ f —-- • " i•"i " fi .! + r- ,Y- ` .' '. 5 �I Photo Two Photo Two Caption RIGHT VIEW FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6 , _ __. ... , f l' UG OUT 5951JacksonvilleArlingtonFloExpresswayrida32211 'VP' SER VICE Phone 904-743-8272 bugoutservice.com Toll Free 1-877-BUG-U-OUT TERMITE TREATMENT RECORD / CERTIFICATE OF COMPLETION Bug Out Service, Inc. verifies to the Builder, Building Inspector, Homeowner, and Lending Institution, in compliance with Florida State Law (Chapter 482-226), this building has received a complete treatment for the prevention of subterranean termites.Treatment is in accordance with the rules and laws established by the Florida Department of Agriculture and Consumer Services.An annual inspection and renewal of the annual termite protection contract is I necessary for continued protection. 1 Sao sr, ATiiC &MN /7. Location of Property(Street Address,City and State) Lot Block 1 If termite infestation should occur within one year from the date of treatment in this building, Bug Out will retreat the 1 structure using the standards in effect at the time of retreatment. The property owner shall have the option of extending the limited warranty beyond the first year for no less than four additional years. If during the term of this guarantee, additions or alterations are made which affect the structure and create new termite hazards, or interfere with the treatment method used, this guarantee will become null and void. Soil Treatment' Technician Treatment Treatment Record Date Record Time Chemical Used: Premise Pre X Other ALT 11 2I5 Concentration:0.5% / 1 /2//i/ /?i0 Gallons applied:?Aq Method of application: 1� Pressure sprayed Soil rodded 1l 12J/1/ / Square footage of soil area treated: 77(07 Linear ft.of Masonry Voids treated: /L 12`//L/ f00 Tubs and Traps Final Soil Treatment: 2-767 IS_ I Zi'1/ 17 Wood Treatment: Chemical Used: Bora-Care Concentration 1:1 Solution Framing area treated: 24 inch barrier treatment Method of Application: Pressure sprayed Gallons Applied Baiting System: ASentricon' Product Used: Sentricon Colony Elimination System Linear Feet: Colony Elimination System Monitoring System: i4 Product Used: Linear Feet: Builder: �' /7 /BY( gnature):Si ' Date: /2 /fi//6 Title: � White-Job Site Canary-Bug Out Reorder from Rush to Excellence 904-367-0100 Form#4045 Rev 08/14 --- -- -- 1 I LEGACY LEG6424AEACH BOULEVARD INCCY ENGINEERING, JACKSONVILLE, FL 32216 ENGINEERING, INC 904-721-1100 OFFICE ProjectNo.: 904-722-1100 FAX Report No.: Geotechnical&Materials Engineering and Testing page of Lab No.: , Report of In-Place Density (Asphalt or Soil) Tests or Coring for Thickness(-- circle one--) Project: ) ( ) ' ,' 1 vc.• -+ „ Re t- Contractor: 1/r/,.:, , Zo,,A;..h Method: i...) -7 s z-2 Reported To: ,/_ Location by: , Location: '4,,,k.e Pia,> - s r, Course: ' i e c Material: --.77- ,gyp 6,r Spec. Requirements: 9} - Date Tested: i Z -/y-' amass/ Location Elev/ Base/LR/ Dry Max. % of Moist Fail/ Depth/ Asphalt Density Dry Max % • Retest Lift Thickness Density* Den li 1 / ,/ 1OC� CO /amu X `I . i 4 12 / ,,,,, i r' 7.9,7 -/?...-4,-/ G',' ! ? (- '7* D 2 / / *Source of Proctor(Project Number) P- Test Meets Specification Requirements F- Test Fails To Meet Specification Requirements R- Retest A _IQ IikeSstmnOe ed In Field Employee Name a=-_f—— 0-Standby Time from to Total: BillingComments � 0-Job Time from to Total: Trip Charge(Job Canceled) 0-Travel Time from to Total: (To job) Out of Town Mobilization ❑-Travel Time from to Total: (From Job) City Total Hours: i. White Copy-Office Use Yellow Copy-Field Box Pink Copy-Personal Use (Office use)