1902 SW 22ND AVEAddress:
Legal:
1902 S.W. 22 Avenue
9/14/78
10/13/~
6/29/79
8/15/79
4/18/80
LEISUREVILLE, SEC. 10
Blk: 101
Lot: 14
Issue Permit
Date No. Contractor Architect Owner Valuation
78-1798 Campanelli Lauderman Boynton W
78-1798
78-1798
79-1743
80-090(
Jackson
D. L. Norris
Nadeau
Gutters & S~
tters
same
same
Shoner
same
45,709.
1,408.
1,500.
300.
152.
Fee
22:
15
8
8
Use:
Single Family 2/2
Zone: PUD Water: $ 125.00
Microfilm: Sewer: $ 250.00
Final
Date
5/30/79
1/26/79
5/30/79
7/2/79
8/16/79
4/18/80
penalty
C.O.
Purpose
New s/f 2/2 10 Fix
Walks & Drives
roof
awnings
decor block
gutters & d/s
Issue Permit Final
Date No. Contractor Owner 'Valuation Fee Date Purpose
11/9~9~/78 78-1798 Peerless Boynton W. 50. 5/~9/79 new
I
MECHANICAL
Issue Permit Final
Date No. Contractor Owner Valuation Fee Date Purpose
19./5/78 78-1798 Air Aide Boynton W. 15. 5/30/79 a/c
Issue
Date
12/7/78
PLUMBING
Permit
No.
:78-1798
Contractor
Mi~ Fla.
Owner
Boynton W.
Valuation
Fee
26.
Final
Date
5/30/79
Purpose
new 10 fix.
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Important: Read the instructions on pa~es 1 - 7,
SECTION A- PROPERTY OWNER INFORMATION
O.M.B. No. 3067-0077
Expires December 31,200.~
For Insurance Company Use:
_E~.UILDING OWNER,;¢ NAME,,.,. - /" ~ C' n . , 4 '~
i,~UI,,.I~LD,~ING .~[~", A~DRES~(~g~., Un~, Suite, ~n¢oCg.~.) O~.O. ROUTE AND BOX NO.
~ STATE ZIP ~ODE/
' ~RO~R~ DESCRIPTION (Lot ~d Bilk Numbem, Tax P~I Nu~r,.~al ~scdption, etc~ . . / ~ . . _.
BUILDING USE (e.g., Re~e~, Non-r~identi~, Additi~, A~sow, etc. Use ~C~men~ ~, ~ n~ssaw.)
~Ti~UD~ONGITUDE (OPTIONA%) HOR ZONTAL DATUM: SOURCE: ~ G ~yp )
( ~o~ ~,. ff¢.~¢, or ~.~¢~ ~ NAD 1927 ~ NAD 1983 ~ USGS Quad Map
Pdicy Number
Company NAIC Number
SECTION B- FLOOD INSURANCE RATE MAP (FIRM)INFORMATION
NUMBER B5. SUFFIX B6 I E EFFE..~TI~'E/REVI/SED DATE
I
TE
I B9. BASE FLOOD ELEVATION(S)
B8. F~j_D~NE(S) (Zone AC, use dept~ ol flood,ng)
B10 Indcate the so~rce of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
[] FIS Profile [] FIRM [] Communily Determined [] Other (Describe):
Bll. Indicate the elevation datum used for the BFE in B9: [] NGVB 1929 [] NAVD 1988 [] Other (Describe):
B12. Is the buildir~ located in a Coastal Barrier Resources System/CBRS/ area or Othe~se Protected Area/CPA)? [] Yes [] No Designation Date __
SECTION C- BUILDING ELEVATION INFORMATION (SUR~EY REQUlREB)
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.
C2. Building Diagram Number [ (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 bullring, pro,,dde a sketch or photograph.)
C3. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, Vl-V30, V (with BFE), AR, AR/& AR/AE, AR/A1 -A30, AR/AH, AR/AC
Complete Items C3.-aq 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 ~n
Section B, conver~ the datum to that used for the BFE. Show field measurements and datum conversion calculafdon. Use the space prowded or the Comments area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum I°~.~c~ ConversioWCom~ents
Elevation fete"fence mark used ~..~Does the elevation reference mark used appea[on thee FIRM? [] Yes [] No
Q a) Top of bottom floor (including basement or enclosure) ~L. L~ft.(m)
·
· __ft.(m)
· _ft.(m)
.
·
__,sq. in. (sq. cra)
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
SCANNEE
AUG - 6 2003
BUILDING D/V/SI(
~1 b) Top of next higher floor
Q c) Bottom of lowest horizontal structural member (V zones ody)
..3 d) Attached garage (top of slab)
3 e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area)
~1 f) Lowest adjacent (finished) grade (LAG)
~J g) Highest adjacent (finished) grade (HAG)
~1 h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
L3 i) Total area of all permanent openings (flood vents)in C3.h
)N
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 in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
I understand tha~ any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
TITLE COMPANY NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. For lnsuranoe Company Use:
Policy Number
.8.UILDING.. STREET ADDRESS (Induding Apt.,~nit, S~, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
oD.
"'-" ti SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Company NAtC Number
Copy both sides of this Elevation Certificate for (1) community official, (2)insurance agent/company, and (3) building owner.
COMMENTS
[] Check here if attachments
SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), cor:nPlete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F.
Section C must be completed.
El. Buildr~ Diagram Number_(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.)
E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) [] above or [] below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) __in.(cm) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(cm) [] above or [] below (check one) the highest adjacent grade. (Use
natural grade, if available).
E5 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 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
'l-he property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), 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, C, and E are correct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS 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 item(s) and sign below.
G1 ..~'The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or IcoaJ 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 AC.
G3. [] The followthg information (Items G4-G9)is provided for community floodplain management purposes.
I ,P R,,TNi Rfl'' r . , , D ITEPER IITISSuED
G7. This permit has been issued for. ~' New Construction [] Substantial Improvement
0,8. Elevation of as-built lowest floor (including basement) of the building is:
Gg. BFE or (in Zone AC) depth of flooding at the building site is:
LOCAL OFFICIAL'S NAME~
G6. D/~TE CERTIFICATE OF COMPLIANCE/(X;CUPANCY ISSUED
TITLE - '
COMMUNITY NAME
COMMENTS
BATE O~- ~Z:7~ (~,__~
~]'1:~heck here if attachments
FEMA Form 81-31, January 2003 Replaces all previous editions
- 1
DESCRIPTION
LOT /,¢', BLOCK lOt, PLAT OF TENTH SECTION
PALM BEACH LEISUREVILLE. CITY OF 80YNTON BEACH
FLORIDA, ACCORDING TO THE PLAT THEREOF ON FILE
IN THE OFFICE OF THE CLERK OF THE CIRCUIT COURT
IN AND FOR PALM BEACH COUNTY, FLORIDA. RECORDED
IN PLAT BOOK 30. PAGES: 129 THRU 141
o/////////c' PZtVEh,I EI,/T ¢
~ Of Boynton Beach
SU(II)tvISION: P~L~ 8EACH L£1$UREVILI_E
N~.. ~ E 07
~RESS:/~ S.W. ~2ND. AVENUE..
ENGIN~EHS, I~C.
P. O, BOX 310
~ - ~u~. , ~Uhl . I STORY
FII';. FLG')R ELEVI~TIOt.~'
PLO~ PL;.:; CF ;HE
ABOVE DIESCRIBED PROFERyy
P~'LM ~EACH COUNTY, FLORIDA
FOR
~O~NTO~~ WEST DSV~LOP~EN'~ C~O~~~
AUG-6 20113 ..... .
BUILDING DIVISION