5300 Island BLVD (2)&ULULAIJUT
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660 -0008
National FloW,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 WILLIAMS ISLAND POA Policy Number:
t2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No Company NAIC:Number
5300 Island Blvd.
City Aventura State FL ZIP Code 33160
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Folio No. 28.2210 -066 -0020, Miami -Dade County, Florida.
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Non - residential
A5. Latitude /Longitude: Lat. 25 °46'41.1" Long. -80 °08'15.7" Horizontal Datum: ❑ NAD 1927 E NAD 1983
AS Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number _1B
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 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 E No d) Engineered flood openings? ❑ Yes ® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP Community Name & Community Number B2. County Name B3. State
City of Aventura - 120676 Miami -Dade FL
B4. Map/Panel Number B5, Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone
1208600134 L 9 -11 -09 Effective /Revised Date Zone(s) AO, use base flood depth)
9 -11 -09 AE 9
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other /Source:
B11. Indicate elevation datum used for BFE in Item B9: E 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 E No
Designation Date: N/A ❑ 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/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: MDCBME218. Elev. 7.00 Vertical Datum: NGVD 1929
Indicate elevation datum used for the elevations in items a) through h) below. E 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)
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
I) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
L6
E feet
❑ meters
N /A._
E feet
❑ meters
N /A.
E feet
❑ meters
N /A._
E feet
❑ meters
10.3
E feet
❑ meters
9.2
E feet
❑ meters
9.5
E feet
❑ meters
9.3
E 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 100
E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided a
E Check here if attachments. licensed land surveyor? E Yes [I No
Certifier's Na niel C. Fortin License Number LS2853
Title R . Land urveyor Company Name Fortin, Leavy, Skiles, Inc. 130101
re 18 NE 168th Str City N. Miami Beach State FL ZIP Code 33162
S' u iii/ Date 3113/13 Telephone (305) 653 -4493
13, 2
Daniel C. Fort
RLS 2853
State of Flor -
FEMA Form 086 -0 -33 (7/12) See reverse side for continuation. Replaces all previous editions.
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.
5300 Island Blvd.
City Aventura State FL ZIP Code 33160 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 5: La N de 8 Longitude were established by LABINS survey data interactive map
Crown of I ation +8.9.
Item QWiselectibal outlets at elevation 10.8.
Signature Date 3/13113
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.
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
Aaaress 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 items) and sign below. Check the measurement used in Items G8–GI O. 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.)
G1 ❑ 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.
Permit Number
G5. Date
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
El meters Datum
Local Gfficial's Name Title
Community Name Telephone
Signature Date
Comments
Check here if attachments.
FtMA Form 086 -0 -33 (7/12) Replaces all previous editions.
U.S. DEPARTMENT OF HOMELAND SECURITY FLOODPROOFING CERTIFICATE OMB No. 1660 -0008
-7fftkd EMERGENCY MANAGEMENT AGENCY FOR NON - RESIDENTIAL STRUCTURES Expiration Date: July 31, 2015
National Flood bunrana Pro B ram
The floodp((o��fi,ng�of non - residential buildings may be permitted as'an' alternative to elevatingtd'or above the - Base 'Flood Elevation;
however, a`}ibdg�ibuafing design certification is required. This form is to be used for that certification. Floodproofing of a residential building
does not after -a community's floodplain,mana&MlentelevationrequirerAents or affect the insurance rating. unless the community has been
issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a
separate certification specifying that the design complies with the local- floodplain management ordinance.
FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME
POLICY NUMBER
ADDRESS (inOtuding Apt., Unit, Sute, and /or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
COMPANY NAIC NUMBER
OTHER DESCRIPTION (lot and POO Numbers, etc;
STATE ZIP CODE
CITY )Iz�4-.
SECTION I - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from
COMMUNITY NUMBER
the proper Flefm:
PANEL NUMBED
SUFEI%
_F
DATE OF FIRM INDE%
i1RM EONE
BASE ELEVATION
in Ad Zones, Use Dephn
Elevations are based on: cokonshuction Drawings ❑ Building Under Construction ❑ Finished Construction
far Base Flood Elevation shown above: P$RGVD 1929 ❑ NAVD 1988 ❑ Other /Source:
Indicate elevation datum used
SECTION 11 - FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect)
Elevations are based on: cokonshuction Drawings ❑ Building Under Construction ❑ Finished Construction
Floodproofing Design Elevation Infor�m✓rat`ion; I
Building is floodproofed to an elevation of f-- feet (In Puerto Rico only _ . — meters). *NGVD 1929 ❑ NAVEL 1988 ❑ Other /Source.
(Elevation datum used must De the same as that used for the Base Flood Elevation.) 3
Height of floodprooRng on the building above the lowest adjacent grade i5 feet (In Puerto Rico only: meters).
For Unnumbered A Zones Only: a�
to the building (HAG) . feet (In Puerto Rico only —. — meters)
Highest djacEnt (finished) grade next —L
GVD 1929 ❑ NAVE) 1988 ❑ Other /Source:
the building's floodproofed design elevation must be at least 1 foot above the Base Flood Elevation to receive rating credit. If the Duilding
(NOTE: for insurance rating purposes,
is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result in a higher Dremium.)
SECTION 111- CERTIFICATION (By a Registered Professional Engineer or Architect)
Non - Residential Floodprooled Construction Certification:
the design and in otconstruction
1 certify that, based upon development and /or review of structural design, specifications, and plans for construction,
are m accordance with accepted standards of practice for meeting the following p(ovisions:
The structure, together with attendant utilities and. sanitary facilities, is watertight to the floodproofed design elevation indicated above, with
walls that are substantially impermeable to the passage Of water.
Q
All. structural components are Capable of resisting hydrostatic and nydrodynamic flood IOTCeS, including the effects Di buoyancy, and amicipated
debris impact forces .
t 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 orimprisonmenwrider 78. US. Code. Section 1001.
CERTIFIER'S NAME LICENSE NUMBER for Aron Seal)
TIP -E COMPANY NAME
Aa II
�i�%J /
CITY STATE ZIP CODE
ADDRESS
6/
i /
DATE PHONE
SIGNATURE
/ es should be made of this Certificate for: 1) community official, 2) Insurance agent /company, and 3) building owner.
FEMA Form 086 -0 -34 17/121 REPLACES ALL PREVIOUS EDITIONS F -05C