Flood Control - Elevation Certificate - 2555 N Vizcaya - Vizcaya Subdivision - 7/23/2013U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9.
OMB No. 1660-0008
Expiration Date: July 31, 2015
SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owners Name Roger & Stacy Schneider Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. Company NAIL Number:
City Eagle State ID ZIP Code 83616
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Vizcaya Subd., Lot 29 Blk 1, PARCEL #R9048110340
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/ Longitude: Lat. 41-43-03 q9 N Long. 116-20-16.06 W Horizontal Datum: ❑ NAD 1927 ❑x 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 9
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) 1767.5 sq ft a) Square footage of attached garage 1375 sq ft
b) No. of permanent flood openings in the crawlspace or N/A b) Number of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade N114
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b NIA sq in
d) Engineered flood openings? ❑ Yes N No d) Engineered flood openings? ❑ Yes N No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
62. County Name B3. State
I
GARDEN CITY Y - 160004
ADA ID
84. Map/Panel Number
B5. Suffix
B6. FIRM Index Date
B7. FIRM Panel Effective/
B8. Flood Zone(s)
B9. Base Flood Elevation(s) (Zone
❑ meters
Revised Date
❑ meters
A0, use base flood depth)
16001 C 0166
H
09/22/1999
02/19/2003
AE
2615.5
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item 89:
® FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source:
Bll. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes N No
Designation Date: / / ❑ 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, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/A0. Complete Items
C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: PID AH7375 Vertical Datum: 2671.52
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the RFE
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)
f) 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
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. l 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.
❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here If attachments. licensed land surveyor? ® Yes ❑ No
DEAN BRIGGS
Title
-S
idre
180 OVERLAND 14
Signgru
A Form 086-0-33 (7/12)
License Number
PLS 3619
Company Name
Check the measurement used.
2617.
7
® feet
❑ meters
2620.
7
N feet
❑ meters
N feet
❑ meters
2619.
9
❑R feet
❑ meters
2620.
7
N feet
❑ meters
2618.
9
N feet
❑ meters
2619.
2
N feet
❑ meters
2619 ,
2
N 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. l 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.
❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
❑ Check here If attachments. licensed land surveyor? ® Yes ❑ No
DEAN BRIGGS
Title
-S
idre
180 OVERLAND 14
Signgru
A Form 086-0-33 (7/12)
License Number
PLS 3619
Company Name
BRIGGS ENGINEERING, INC.
City
State
BOISE
ID
Date
Telephone
07/27/2013
(208) 34
See reverse side for continuation.
ZIP Code
83705
o SLSTA
1 3619
Replaces all previous editions.
ELEVATION CERTIFICATE, page 2
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 P0. Route and Box No. Policy Number:
City State ZIP Code( Company NAIC Number:
Eaale ID 83616
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 Furnace andAter Heater in Garage at Living Space Finished Floor Elevation
Date 07/27/2013
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 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. 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 A0.
G3. ❑ The following information (Items G4 -G9) 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
omments
❑ Check here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS
See Instructions for Item A6.
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 P0. Route and Box No. Policy Number:
2555 N. Vizcaya Way
City State ZIP Code Company NAIC Number:
Eagle ID 83616
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
EAST SIDE
A
T
i
WEST .sin
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS
Continuation Page
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 PO. Route and Box No. Policy Number:
2555 N. Vizcaya Way
City State ZIP Code Company NAIL Number:
Eaqle ID 83616
Identify all photographs with:
pplicable, photographs must
A8.
NORTH SIDE
SOUTH SIDE
-6
FEMA Form 086-0-33 (7/12) Replaces all previous editions.