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ELEVATION CERTIFICATE U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency OMB No. 1660-0008 National Flood Insurance Program 2 0 — ' p 3y Expiration Date:November 30,2022 ur ELEVATION CERTIFICATE Important Follow the Instnuclions 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. WOOSTER A2. Building Street Address(including Apt,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Company Mc-VC Number. 848 EAST DRIVE City State ZIP Code BOYNTON BEACH Florida 33435 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 48 AND 13 HARBOR ESTATES A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENCE A5. Latitude/Longitude: Lat 26.53862 Long.-80.05267 Horizontal Datum: ❑NAD 1927 Z NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Build-mg Diagram Number 1A . A8. For a building with a aawlspace or enclosure(s): . a) Square footage of aawlspace or endosure(s) 0.00 sq ft b) Number of permanent flood openings in the crawlspace or endosure(s)within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in AB.b 0.00 sq in d) Engineered flood openings? ❑Yes ® No A9. For a building with an attached garage: a) Square footage of attached garage 770.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 4 c) Total net area of flood openings in A9.b 800.00 sq in d) Engineered flood openings? ®Yes 0 No SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION . Bl. NFIP Community Name&Community Number B2. County Name B3_ State 125196 BOYN TON BEACH PALM BEACH Florida B4. Map/Panel 85.Suffix 86. FIRM Index B7. FIRM Panel 88. Flood 139. Base Flood Elevations) Number Date Effective/ Zone(s) (Zone AO,hue Base Flood Depth) Revised Date 12099C0791 F 10-05-2017 10-05-2017 AE 7 810. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9: 0 FIS Profile ® FIRM ❑Community Determined 0 Other/Source: 1311. Indicate elevation datum used for BFE in Item Ba 0 NCVD 1929 ® NAVD 1988 ❑ Other/Source: . : 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® No Designation Date: ❑ CBRS 0 OPA FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 1 of 6 OMB No. 1680-0008 ELEVATION CERTIFICATE Expiration Date:November 30,2022 IMPORTANT:In these spaces,copy the conespommng information from Section A. FOR INSURANCE COMPANY USE Building Street Address(mdudng Apt.Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. 848 EAST DRNE City State ZIP Code Company NAIC Number BOYNTON BEACH Florida 33435 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑Buildmg Under Construction* ID Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations—Zones Al A30,AE,All,A(with BFE),VE,Vi—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: PALM BEACH COUNTY BM Vertical Datum:1988 Indicate elevation datum used for the elevations in items a)through h)below. ❑ 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) 8.0 ❑ feet ❑ meters b) Top of the next higher floor 20.0 ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑ feet 0 meters d) Attached garage(top of slab) 65 ® feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 8.0 ❑ feet ❑ meters o Lowest adjacent(finished)grade next to building(LAG) 6.0 0 feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 6.3 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support ❑ 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 evadable.I undef Aar/d that any false statement maybe punishable by fine orimprisonment under 18 U.S- Code, Sekrion 1001. Were latitude and longitude in Section Arovided p by a licensed land surveyor? ®Yes 0 No O * gf merits Certifier's Name License Number ,A "° HARRY BURGESS 5089 ., ' a The • tit : �' LAND SURVEYOR ( Company Name RENNER BURGESS SURVEYING ' r '`"fit 4 . Address ^`, q cA" ' 801 SE 6TH AVE SUITE 203 p1 ' p-t, City . , _ State ZIP Code 17,199,1 - D • B •,•CH Florida 33983 Sig .I Date Telephone � 06-17-2021 (561)243-4624 r%•' tic of this Elevation Certifi.:it:mall attachments for(1)community official,(2)insurance agent/company,and(3)building owner.ents(including type of equipmen and location,per C2(e),if applicable) C2E=GENERATOR PAD NC PAD A9t 4 SMART VENTS MODEL 1540-520 C 200 SQ FT EACH FEMA Form 086.0-33(12/19) Replaces all previous editions. Form Page 2 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expition Date:November 30,2022 IMPORTANT:In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address(indudmg Apt,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number. 848 EAST DRIVE City State ZIP Code BOYNTON BEACH Florida Company NAIC Number 33435 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 El—E5. If the Certificate is intended to support a LOMA or LOMR-F request complete Sections A,Band 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, aawlspace,or enclosure)is 0 feet ❑meters ❑above or ❑below the HAG. b) Top of bottom floor(including basement, aawlspace,or endosure)is ❑feet ❑meters ❑above or 0 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 Cab in the diagrams)of the building is 0 feet 0 meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is 0 feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet 0 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 0 No ❑ Unknown. The IoM official must certify this information in Section G. SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The erty owner or community-issued ed B E)or Zone AOwners rized mustsign here.representative who statementsmeiletes Sections inn Sections A.A,Band E are coned to the and E for Zone A(without best of knowledge.FEMA-issued or my Property Owner or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments • ❑Check here if attachments. FEMA Form 086.0.33(12/19) Replaces all previous editions. Form Page 3 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date:November 30,2022 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. 848 EAST DRIVE City State ZIP Code BOYNTON BEACH Florida MAIC Number Florida 33435 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,8,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. 0 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 0 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 35. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for. 0 New Construction❑ Substantial Improvement G8. Elevation of as-built lowest floor(including basement) of the building ❑feet ❑ meters Datum 69. BFE or(in Zone AO)depth of flooding at the building site: 9 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) 0 Check here if attachments. FEMA Form 086-0-33(12/19) 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 30,2022 IMPORTANT:In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address(induding Apt,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Pdiq Number 848 EAST DRIVE City State ZIP Code Company NAIC Number BOYNTON BEACH Florida 33435 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 Vie W';and,if required,"Right Side Viex/'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 ft on this page,use the Continuation Page. y ni`AN111ly�'` , v A "fh 4q y lv l ,W, M„ " Ol' 'w^„ "fir. ! r . lw� �r tugya"w wr. m"Id°°, 'Y ,u,� v :r" s ^" e �Y ,sir "Hi' � Awa ro Photo One Photo One Caption FRONT VIEW 6-16-2021 I Clear Photo One 6 \ ac"yYw. )` i ru , v ,u " y ,dwrn � +aa y�yy,�, f AW $� 1 M w�. N tARL ^"'"'•! q� y9Q\" oft. ' /t YMn Yt ! W' F y i ,, p der.tti 4,.. �1,N .4,J tvi, .,t ' .. { w.,: M w5 tpp , „ 4, mt . .N.V wwA �Wfi WI1�1 pnpy VW r L Photo Two Photo Two Caption REAR VIEW 6-16-2026 � Clear Photo Two FEMA Form 086-0-33(12/18) Replaces all previous editions. Form Page 5 of 6 • BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date:November 30,2022 IMPORTANT:In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address(induding Apt.,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number 848 EAST DRIVE City State ZIP Code Company NAIC Number BOYNTON BEACH Florida 33435 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 . - • m lrrr Ixm ,: • ,rte f. • • Prom toes Photo Three Caption LEFT VIEW 6-16-2021 I Clear Photo Three .s �9Voia : �lrrc r �r ✓h+p.mr a4re Xwu•c " "` . �1r�L.. '"'1,, atu „`e` , \ d 1 ` N4 1 a mmm X yi6 11 w � % tw ,r w Pi , n ', 40 �� \� 3 iYM�t{Idri II w of V , 1 , �Illi � +�r7\ Yt r4F�'14�YV�rt9141"�r � ir Photo Far Photo Four Caption RIGHT VIEW 6-17-2021 1 Clear Photo Four FEMA Form 086-0-33(12/19) . Replaces all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB Na 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date:November 30,2022 IMPORTANT:In these spaces,copy the corresponding infonnatlon 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 848 EAST DRIVE State ZIP Code City Company NAIC Number FloridaBOYNTON BEACH 33435 2 building according to the PhotograPhsred:bel"ri' M Side View"and If using the Elevation Certificate to obtain NFIP flood insurance, aTfixi instructions for Item A6. Identify all photographs with date taken;"Front .onat awithind ireer:resentatiViet'vElendaaffmre;resi theiggssd openings or ephotographs must show the foundation Ivetenftts,SasideinVidiewcateldWinieSnecbaPonPliA8cabl. If'submito—ng more photographs than will fit on this page,use the Continuation Page. Prom One I Photo One Caption VENT 1VIEW 6-16-2021 Clear Photo One 4,4 ge4 g, to, 4,44 ,tith,tgY1'010i;4:41/4.i )0' , • , , kqv 1144'' FIKSO 1440 I Photo Two Caption VENT 2 VIEW 6-16-2026 Clear Photo Two Form Page 5 of 6 Replaces all previous edition& FEMA Form 086-0-33(12/19) • BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date:November 30,2022 IMPORTANT:In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address(induding Apt,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. 848 EAST DRIVE City State ZIP Code Company NAIC Number BOYNTON BEACH Florida 33435 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs Vi 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. �4y~wa Plmlo llree Photo Three Caption VENT 3 VIEW 6-16-2021 Clear Photo Three 14. \ w . ' 11 a 4\ t \ j1* Y ll�ly ",' ixa^'•""'., t l4. Y `xnm kY+ y�' �> - .Y t',"r• e .ipv dacn 11' y n « a� ";yhe4 " p ill r"" MOW Fou, Photo Four Caption VENT 4 VIEW 6-17-2021 I Clear Photo Four Form Page 6 of 6 FEMA Form 086-0-33(12/19) Replaces all previous editions.