18295 Biscayne BLVDFEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
FLOODPROOFING CERTIFICATE
FOR NON-RESIDENTIAL STRUCTURES
The IlctdpreD!ing c! nond &sidarra! Ovildings may bs permitted as an alternative to elevating to or above the Base Flood Elevation;
however, a f'oodproofing design ca.^Ihcation is requirCd. This form is to be used for that certification. Floodproefing of a residential
buoo ng does not altar a community's 1lsooplain management elevation requirements or effect rho insurance rating unless the
m ^'muni!y has Caen ss ;red an &sepvon Dy FE SfA fc allow l.'DOC'prooled revdantia! basements. The permitting via floodprooled
;PS dermal DaSsror; is quires a seperate certification specifying Mal the design complies with the local floodplain management
ordinance.
FOR INSURANCE COMPANY USE
eu- .DINGOWn RS 'aFIE PC41CV NUAI[iER
l cZ� CJapl Co , I� I G �L F1aSEE !A1SS�1hlCsto1 1�1S2rV�� -- — — jA --
GJXIPA,YY NAIC NUMEER
ci..c TpAD�DZ [j5 P C q > tl /: ccI ♦ a w liAo YunLU hOR PG ACUTE AND a0X fNMSER
- —_
OTHER DESCRIPTION,ld. 'Q b4X}N m
MLA+�II DAVE cou11_-
CiTY
TAlt ZIP CODE
SECTION 1 FLOOD INSURANCE RATE MAP (FIRM) INFORM
TION
PrO,ida the loilowlr:q Imm me proper FIRM:
F Ci8A1R.li :�Y NN4NLFi. GAIN <yINWAeEH :'JF`CIR &ATE GF FtlIM IN(O�cX F :FM ZLkiE aASE FLOOO ELEVATICH
(A Aq 2orLw,uaf
035 b U —I. - _l5 `/ i
SECTION It FLOODPROOFING INFORMATION (By a Registered Professional Engk:aer or Architect)
Floodprooling Design Elevation Information:
Building is l: ;,odprooled to an elevation of '�_;,_- ,i,Ig'.. feet NGVD. (Eluvatior datum used must be the same as that
on the FIRLL)
cc
neigh'. of Aoadproohng on the building abovE the lowest adaoenl grade is (. - -1.i6 test.
(NOTE. for insurance rating purposes, Ind buildings Noodprooted design elevation must De at feast one foot above the
Base Flood Elevation, then the
Base Flood Elovalron to receive rating credit If the building is Roodproo!ed only to the
bui!di.rg's insurance rating will result in a higher premium.)
SECTION III CERTIFICATION (By a Registered Professional Engineer or Architect)
Nun- Rasldentlal Floodproofed Construction Cartlllcatlon:
1 cenify Lnat based upon development and'or review of structural design, specifications, ancipti for cons!rucion fine!
the design and moMOds o.' construction are in accordance with accepted standards of practice for meeting the fe8owtng
provisions:
T,, ^,e structure, together with anendant utilities and sanitary facilities, is we•enight to ine Iloodproo.`ed design
ee,ation Indicated above. with walls that ate substantially impermeable to me passage of water.
Ali structural components are capable of resisting hydrostatic and hydmdynari liood forces, including -:he
e "ects of buoyancy, and anticipated debris impact forces.
I certify that N +e information on this certificate represents my best efforts to interpret the data available. 1 understand that
any lots& statement may be punishable by line or imprisonment under 18 U.S. Code, Section 1001.
L[RTIFIERS NAM,. LICENSE NUi P ji,, Aft stet
TITLE C.QdPANY
,CD ,Ei��� GQ�tp� -�'+
ATE
92 1
Copies should bn made o !s Cerllflcata for: 1) communlhy official, 2) Insurance agenVcompany, and 3) bullding own »r.
FEMAForn Bl 65. FEP. 97 IEPIACES ALL PREVIOUS EDfii,-)hS W00561 /97I
1 -14
_ Ol_ - JCrlri I k "JJI,
IMr W. TANT: In these apacas, copy the coM,- 0ondtng Information from Sactlon A. � Farinquiance Company Use,
PUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Polley Number
13.-Ol Biscayne Blvd.
4lamti STATE Florida 713328E :Company NAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINJED)
both sides of this Elevation Certificate for (1) community official, (2) insurance agentloompany, and (3) bulding owner.
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIREDI FOR ZONE AO AND ZONE A (WITHOUT BFE)
or Zone AO and Zone A (without BFE), complete Items E 1 through E4. if the Elevation Certificate is Intended for use as supporting
formation for a LOMA or LOMR -F, Section C must be completed,
1. Building Diagram Number _(Select the building diagram most similar to the building for whIr h this certificate Is being completed - see
Pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
2. The top of the bottom trdaf j nckalfto basement or enclosure) of the building Is _ ft(m) - atri.(M) 0 abovo or C] below (check onb)
the highest adjacent grade,
3. For Building Diagrams 6.8 with openingg. (see page 7), the nerd higher floor or elevated floor (elevation b) of the building Is
_ ft.(m) _In.(cm) above the highest adjacent grade,
a. For Zone AO only: If no flood depth number is available, Is the top of the bottom floor elevated in accordance with the community's
floodclain manaaan,antnrdlnance? n Yaa f7 No C7 Unknown: The local oA9dal must Cox* this information In Section G.
fhe property owner or owner's authorized representative who complsfea Sectlons A, B, and E for Zone A (WIthout a FEMA- Issued or
:ammunlry- issued BFE) or Zone AO must sign here.
'ROPERTY OWNER'S OR OWNER'S AUTHORIZED ORIZED REPRESENTATIVE'S NAME
aDnRESS CITY STATE ZIPCODE
TURE DAT TELEPHONE
if attachments
SECTION G - COMMUNITY
)e local official who is authorized by law or ordinance to administer the community's floodptaln management ordinance can complete
actions A, B,,,C (or'E},'and G of this Elevation Certificate. Complete the applicable ram(a) and sign below.
1. ❑ The•ift"atlon in Becton C was taken from other documentation that has been e�nad end emboese_d by s N%!Lsed survilygf,
eAg),t'*e or anhtptb�twho is out ortzed by state or local law to coNfy elevation Information. (Indicate the source and date of the
talevRW data dp th#i C(immente area below.)
2. ❑ H o6t tuur"Fflclaf er' Oated Section E for a building located in Zone A (without a FEMA- Issued or community- Issued BFE) or
�one.lSO.
3. ❑ flee foWvving Infer- r' t(on (items G4 -G9) is provided for community floodplain management purposes.
ISSUED
7. This permit has been Issued for: ❑ New Construction ❑ Substantial improvement
8. Elevation of es -built lowest floor (Including basement) of the building Is: • - _tt.(m) Datum:
9. BFE or On Zone AO) depth of flooding at the building site is; _ ft-(m) Datum:
_OCAL OFFICIAL'S NAME TITLE
- OMMUNITY NAME TELEPHONE
31GNATURE DATE
❑ Check here if attachments
U 0rV! NO.7U61 r. i
.-iEDERAL EMERGENCY MANAGEMENT AG&.*tY p-M.B. N0. 3067 -0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION CERTIFICATE
Im octant: Read the Insbueflons on es 1 •7. Amended b MDC-DERM- OCT, 1999
SECTION A - PROPERTY OWNER INFORMATION For Insurance Camoanv Use
LL,C.
LATITUOE/LONGITUOE (OPTIONAL)
( #e - #1k - ##.W or ##.##Mw)
Unit, Suite, and/or Bldg.
HORIZONTAL DATUM:
❑ NAD 1927 ❑ NAD 1993
ROUTE AND BOX NO.
SOURCE: GPS (Type);
[] USGS Quad Map [] Other.
SECTION B - FLOOD INSURANCE RATE MAP (FAiM) INFORMATION
NUMBER I I DATE
84 J 7 -17 -95
ZONE(S) (Zone A0, use depth of flooding)
AE 1 71
810. Indicate the source of the Base Flood Elevation (BFE) data orptlia flood depth entered In 69.
❑ FIS Profile ® FIRM ❑ Community Determfied Q Other (Describe):
B11. Indicate the elevation datum used for the BFE in 139: ® NPVP, 1929 ❑ NAVD 1988 ❑ Other (Describe):
812. Is the building located Ina Coastal Bardar Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ®No
Designation Date
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.
Building Diagram Number I (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7, If no diagram accurately represents the building, provide a sketch or photograph,)
C3, Elevations - Zones Al -A30, AE, AH, A ('Kith BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 -A30, AR/AH, AR/AO
Complete Items Cis -I below according to the building diagram specified in item C2. State the datum used. If the datum is different from the
datum used for the BFE in Section B, convert the datum to that used for the BFE: Show field measurements and datum conversion
calculation. Usg_Ilge space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Oatuml2 ohv terslon/Comments BM used N -610, EL. 7.80'
Elevation reference mark used _Does the elevation reference mark used appear on the FIRM? ❑ `res ❑ No
0 a) Top of b6ttom floor (Including basement or enclosure)
A b).Top of next higher floae_.
❑ c) Bottom of lowest horizontal structural member (V zones only) _,ft,(m)
0 d) Attached gaamgs (top of slab) d
0 e) Lowest 06vation of machinery and /or equipment W k -
seM the building ft(m)
❑ f) Lowest adjacent grade (L.AG) 7 '6-ft.(m)
❑ g) Hiloest adjacent grade (HAG) ^ , 2ct7t i
Cl h) No. of permanent openings (flood vents) within 1 A. above adjacent grade 8 31/
/
0 1) Total area of all permanent openings (flood vents) in CA _ _sq ,In. (sq. cm)
SECTION D - SURVEYOR, ENGINEER; OR ARCHITECT CERTIFICATION
This certification Is to be signed and sealed by a land surveyor, engineer, or arc httect authorized by law to certify elevation Information.
I certify that the Itlforma(lon in Sections A, 8, and C on th /s cerUfreete represents allf best efforts to Interpret the data available.
I understand that env false statement maybe punishable bir ire or imprisonment under 18 U.S. Code, Section 1001.