Federal Emergency Management Agency
National Flood Insurance Program
Elevation Certificate
and
Instructions
National Flood Insurance Program
Instructions
Public reporting burden for the Elevation Certificate is estimated to average 2.25 hours per response. Burden means the time, effort, or financial resources expended by persons to generate, maintain, retain, disclose, or provide information to the Federal Emergency Management Agency (FEMA). You are not required to respond to the collection of information unless a valid 0MB control number is displayed in the upper right corner of each form. You may send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (3067-0077). Do not send completed form(s) to the above address. To obtain or retain benefits under the National Flood Insurance Program (NFIP), you must respond to this collection of information.
PURPOSE OF THE ELEVATION CERTIFICATE
The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be used to provide elevation information necessary to ensure compliance with community floodplain management ordinances, to determine the proper insurance premium rate, and to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR-F).
The Elevation Certificate is required in order to properly rate post-FIRM buildings, which are buildings constructed after publication of the Flood Insurance Rate Map (FIRM), for flood insurance Zones AL-A30, AlE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AR, ARIA1-A30, AR/AH, and ARIAO. The Elevation Certificate is not required for pre-FIRIVI buildings unless the building is being rated under the optional post-FIRM flood insurance rules.
As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt a floodplain management ordinance that specifies minimum requirements for reducing flood losses. One such requirement is that the community obtain the elevation of the lowest floor (including basement) of all new and substantially improved buildings, and maintain a record of such information. The Elevation Certificate provides a way for a community to comply with this requirement.
Use of this certificate does not provide a waiver of the flood insurance purchase requirement. Only a LOMA or LOMR-F from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal mandate for a lending institution to require the purchase of flood insurance. However, the lending institution has the option of requiring flood insurance even if a LOMAILOMR-F has been issued by FEMA. The Elevation Certificate may be used to support a LOMA or LOMR-F request. Lowest floor and lowest adjacent ground elevations certified by a surveyor or engineer will be required if the certificate is used to support a LOMA or LOMR-F request.
This certificate is used only to certif~' building elevations. A separate certificate is required for floodproofing. Under the NFIP, non-residential buildings can be floodproofed up to or above the Base Flood Elevation (BFE). A floodproofed building is a building that has been designed and constructed to be watertight (substantially impermeable to floodwaters) below the BFE. Floodproofing of residential buildings is not permitted under the NFIP unless FEMA has granted the community an exception for residential floodproofed basements. The community must adopt standards for design and construction of floodproofed basements - before FEMA will grant a basement exception. For both floodproofed nonresidential buildings and residential floodproofed basements in communities that have been granted an exception by FEMA, a floodprooflng certificate is required.
FEDERAL EMERGENCY MANAGEMENT AGENCY
| O.M.B. No. 3067-0077 Expires July 31,2002 |
| SECTION A - PROPERTY OWNER INFORMATION | For Insurance Company Use: |
| BUILDING OWNER'S NAME
| Policy Number
|
| BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
| Campany NAlC Number
|
| CITY | STATE | ZIP CODE |
| LATITUDE/LONGITUDE (OPTIONAL)
(## - ##' - ##.##" or ##.#####) | HORIZONTAL DATUM:
|_| NAD 1927 |_| NAD 1983 | SOURCE: W GPS (Type): |_| GPS (Type):_________
|_| USGS Quad Map |_| Other: _______________ |
| B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER
| B2. COUNTY NAME
| B3. STATE
|
| B4. MAP AND PANEL NUMBER
| B5. SUFFIX
| B6. FIRM INDEX DATE
| B7. FIRM PANEL EFFECTIVE/REVISED DATE
| B8. FLOOD ZONES(S)
| B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding)
|
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
|_| FIS Profile |_| FIRM |_| Community Determined |_| Other (Describe): _____________________
B11. Indicate the elevation datum used for the BFE in B9: |_| NGVD 1929 |_| NAVD 1988 |_| Other (Describe): ___________
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? |_| Yes |_| No
Designation Date:__________________________
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. 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 building, provide a sketch or photograph.)
C3. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used forthe BFE in Section B, convertthe datumtothat used forthe BFE. Showfleld measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum ____________ Conversion/Comments ______________________________________________________
Elevation reference mark used_____________________ Does the elevation reference mark used appear on the FIRM? |_|Yes |_|No
| |_| a) Top of bottom floor (including basement or enclosure) | ______________ . ___ ft.(m) |
| |_| b) Top of next higher floor | ______________ . ___ ft.(m) |
| |_| c) Bottom of lowest horizontal structural member (V zones only) | ______________ . ___ ft.(m) |
| |_| d) Attached garage (top of slab) | ______________ . ___ ft.(m) |
| |_| e) Lowest elevation of machinery and/or equipment servicing the building | ______________ . ___ ft.(m) |
| |_| f) Lowest adjacent grade (LAG) | ______________ . ___ ft.(m) |
| |_| g) Highest adjacent grade (HAG) | ______________ . ___ ft.(m) |
| |_| h) No. of permanent openings (flood vents) within 1 ft above adjacent grade | __________ |
| |_| i) Total area of all permanent openings (flood vents) in C3h | ________ sq. in. (sq. cm) |
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 that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
| 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
|
| CITY STATE ZIP CODE
| Company NAIC Number
|
|_|Check here if attachments
For Zone AO and Zone A (without BFE), complete Items El through Ei If the Elevation Certificate is intended for use as supporting information for a I..OMA or LOMR-F Section C must be completed.
El. 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 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.
E3. 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.
The property owner or owners 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.
|_| Check here if attachments
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 local 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 AO.
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 is: ____________ -ft.(m) Datum: _________
G9. BFE or (in Zone AO) depth of flooding at the building site is: ____________ ft.(m) Datum: _____________
|_| Check here if attachments
The Elevation Certificate is to be completed by a land surveyor, engineer, or architect who is authorized by law to certify elevation information when elevation information is required for Zones A1-A30, AE, AH, A (with BFE), yE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, or AR/AO. Community officials who are authorized by law or ordinance to provide floodplain management information may also complete this form. For Zones AO and A (without BFE), a community official, a property owner, or an owner's representative may provide information on this certificate, unless the elevations are intended for use in supporting a LOMA or LOMR-F. Certified elevations must be included if the purpose of completing the Elevation Certificate is to obtain a LOMA or LOMR-F.
In Puerto Rico only, elevations for building information and flood hazard information may be entered in meters.
This section identifies the building, its location, and its owner. Enter the name(s) of the building owner(s), the building's complete street address, and the lot and block number. If the building's address is different from the owner's address, enter the address of the building being certified. If the address is a rural route or a Post Office box number, enter the lot and block numbers, the tax parcel number, the legal description, or an abbreviated location description based on distance and direction from a fixed point of reference. For the purposes of this certificate, "building means both a building and a rnanufhctured (mobile) home.
A map may be attached to this certificate to show the location of the building on the property. A tax map, FIRM, or detailed community map is appropriate. If no map is available, provide a sketch of the property location, and the location of the building on the property. Include appropriate landmarks such as nearby roads, intersections, and bodies of water. For building use, indicate whether the building is residential, non-residential, an addition to an existing residential or non-residential building, an accessory building (e.g., garage), or other type of structure. Use the Comments area of Section F if needed.
If latitude and longitude data are available, enter them in degrees, minutes, and seconds, or in decimal degrees, taken at the center of the front of the building. Enter arc seconds to two decimal places. Indicate the horizontal datum and the source of the measurement data (for example, taken with GPS, scaled from a USGS Quad Map, etc.).
Complete the Elevation Certificate on the basis of the FIRM in effect at the time of the certification.
The information for Section B is obtained by reviewing the FIRM panel that includes the building's location. Information about the current FIRM, and a pamphlet titled "Guide to Flood Maps, are available from the Federal Emergency Management Agency (FEMA) website at http://www.fema.gov or by calling 1-800-427-4661. If a Letter of Map Amendment (LOMA) or Letter of Map Revision (LOMR-F) has been issued by FEMA, please provide the letter date and case number in the Comments area.
Item B1. NEW Community Name & Comr~nity Number. Enter the complete name of the community in which the buildinc~ is located and the associated 6-digit community number. For a building that is in an area that has been annexed by one community but is shown on another community's FIRIVI, enter the community name and 6-digit number of the annexing community. For a newly incorporated community, use the name and 6-digit number of the new community. Under the NEW, a "community is any State or area or political subdivision thereof, or any Indian tribe or authorized native organization, that has authority to adopt and enforce floodplain management regulations for the areas within its jurisdiction. To determine the current community number, see the NFIP Community Status Book, available on FEMA's website at http://www.fema.gov or by calling 1-8004274661.
Item B2. County Name. Enter the name of the county or counties in which the community is located. For an unincorporated area of a county, enter "unincorporated area. For an independent city, enter "independent city.
Item B3. State. Enter the 2-letter state abbreviation (for example, VA, TX, CA).
Item B4. Map and Panel Number. Enter the 10-digit number shown on the FIRM panel where the building or manufactured (mobile) home is located. The first six digits will not match the NFIP community number: 1) when the sixth digit is a "C in which case the FIRM panel is in a countywide format; or 2) when one community has annexed land from another community but the FIRM panel has not been updated to reflect this annexation. If the sixth digit is a "C, it is followed by a four-digit map number. For maps not in countywide format, enter the "community panel number shown on the FIRM.
Item B5. Suffix. Enter the suffix letter shown on the FIRM panel that includes the building's location. Item B6. FIRM Index Date. Enter the effective date or map revised date shown on the FIRM Index.
Item B7. FIRM Panel Effective/Revised Date. Enter the map effective date or the map revised date shown on the FIRM panel. This will be the latest of all dates shown on the map. The current FIRM panel effective date can be determined by calling 1-8004274661.
Item B8. Flood Zone(s). Enter the flood zone, or flood zones, in which the building is located. All flood zones containing the letter "A or "V are considered Special Flood Hazard Areas. The flood zones are A, AE, A1-A30, V, VE, Vl-V30, AH, AO, AR, ARIA, AR/AE, AR/A1-A30, AR/All, and ARIAO. Each flood zone is defined in the legend of the FIRM panel on which it appears.
Item B9. Base Flood Elevation(s). Using the appropriate Flood Insurance Study (FIS) Profile, Flood Elevation Table, or FIRM panel, locate the property and enter the BEE (or base flood depth) of the building site. If the building is located in more than one flood zone in Item B8, list all appropriate BEEs in Item B9. BEEs are shown on a FIRM or FIS Profile for Zones AlA30, AE, All, V1-V30, VE, AR, AR/A, AR'AE, AR/A1-A30, AR/Al-I, and ARIAO; flood depth numbers are shown for Zone AO. Use the AR BEE if the building is located in any of Zones AR/A, AR'AE, ARIA1-A30, AR/All, or AR/AO. lii A or V zones where BEEs are not provided on the FIRM, the community may have established BEEs or obtained BEE data from other sources. For subdivisions and other developments of more than 50 lots or 5 acres, establishment of BEEs is required by the community's floodplain management ordinance. If the BEE is obtained from another source, enter the BEE in Item B9.
Item B1O. Indicate the source of the BEE that you entered in Item B9.
Item B11. Indicate the elevation datum to which the elevations on the applicable FIRM are referenced.
Item B12. Indicate whether the building is located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA). Federal flood insurance is prohibited in designated CBRS areas for buildings or manufactured (mobile) homes built or substantially improved after the date of the CBRS designation. An information sheet explaining CBRS areas may be obtained on FEMA's website at http://www.fema.gov or by calling 1-8004274661.
Complete Section C if the building is located in any of Zones A1-A30, AE, All, A (with BEE), VE, VL-V30, V (with BEE), AR, AR/A, AR/AE, AR'A1-A30, AR/All, or AR/AO, or if this certificate is being used to support a LOMA or LOMR-F. If the building is located in Zone AO or Zone A (without BEE), complete Section E instead.
Item Cl. Indicate whether the elevations to be entered in this section are based on construction drawings, a building under construction, or finished construction. For either of the first two choices, a post-construction Elevation Certificate will be required when construction is complete.
Item C2. Select the diagram on pages 6 and 7 that best represents the building. Then enter the diagram number and use the diagram to identify and determine the appropriate elevations requested in Items C3a-g. If you are unsure of the correct diagram, select the diagram that most closely resembles the building being certified, or provide a sketch or photograph of the building and enter all elevations in Items C3a-g.
Item C3. Indicate whether the elevation reference mark (benchmark) used during the field survey is an elevation mark on the FIRM. If it is not, indicate the source and datum for the elevation. Vertical control benchmarks other than those shown on the FIRM are acceptable for elevation determinations. Show the conversion from the field survey datum used to the datum used for the BEE(s) entered in Item B9. All elevations for the certificate must be referenced to the datum on which the BEE is based. Show the datum conversion, if applicable, in this section or in the Comments area of Section D. For property experiencing ground subsidence, the most recently adjusted reference mark elevations must be used for determining building elevations. Enter elevations in Items C3a-g to the nearest tenth of a foot (in Puerto Rico, nearest tenth of a meter).
Items C3a-d. Enter the building elevations indicated by the selected building diagram (Item C2) in Items C3a-e. Elevation for top of attached garage slab (d) is self-explanatory and is not illustrated in the diagrams. If the building is located in a V zone on the FIRM, complete Item C3c. If the flood zone cannot be determined, enter elevations for all of Items C3a-g. For buildings in A zones, elevations a, b, d, and e should be measured at the top of the floor. For buildings in V zones, elevation c must be measured at the bottom of the lowest horizontal structural member of the floor (see drawing below). If any item does not apply to the building, enter "N/A "for not applicable.
Item C3e. Enter the lowest elevation of machinery or equipment in an attached garage, enclosure, or open utility platform that provides utility services for the building. If the machinery or equipment is mounted to a wall, pile, etc., enter the platform elevation of the machinery and/or equipment. if this item' does not apply to the building, enter "N/A "for not applicable.
Items C3f-g. Adjacent grade is defined as the elevation of the ground, sidewalk, patio, or deck support immediately next to the building. Use the natural grade elevation, if available. This measurement must be to the nearest tenth of a foot if this certificate is being used to support a request for a LOMA or LOMR-F.
Items C3b-i. Enter the number of permanent openings (flood vents) in the walls supporting the building that are no higher than 1.0 foot above the adjacent grade. Determine the total area of all such openings in square inches (square cm, in Puerto Rico), and enter the total in Item C3i. If the building has no permanent openings (flood vents) within 1.0 foot above adjacent grade, enter "0 (zero) for each of Items C3h and C3i.
Complete as indicated. This section of the Elevation Certificate may be signed by only a land surveyor, engineer, or architect who is authorized by law to certify elevation information. Place embossed seal and signature in the box next to elevations in Section C. A flat stamp is acceptable only in states that do not authorize use of an embossed seal over the signature of a professional. You are certifying that the information in Sections A, B, and C on this certificate represents your best efforts to interpret the data available and that you understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Use the Comments area of Section D, on the back of the certificate, to provide datum, elevation, or other relevant information not specified on the front.
Complete Section E if the building is located in Zone AO or Zone A (without BEE). Otherwise, complete Section C instead.
Item El. Select the diagram on pages 6 and 7 that best represents the building; then enter the diagram number. If you are unsure of the correct diagram, select the diagram that most closely resembles the building, or provide a sketch or photograph.
Item E2. Enter the height in feet and inches (meters and centimeters, in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram) above or below the highest adjacent grade (HAG). For post-FIRM buildings in Zone AO, the community's floodplain management ordinance requires that this value equal or exceed the base flood depth on the FIRM. Buildings in Zone A (without BEE) may qualify for a lower insurance rate if an engineered BEE is developed at the site.
Item E3. For those communities where this base flood depth is not available, the community will need to determine whether the top of the bottom floor is elevated in accordance with the community's floodplain management ordinance.
Complete as indicated. This section is provided for certification of measurements taken by a property owner or property owner's representative when responding to Sections A, B, and E. The address entered in this section must be the actual mailing address of the property owner or property owner's representative who provided the information on the certificate.
Complete as indicated. The community 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. If the authorized community official completes Sections C, E, or G, complete the appropriate item(s) and sign this section.
Check Item G1 if Section C is completed with elevation data from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. Indicate the source of the elevation data and the date obtained in the Comments area of Section G. If you are both a community official and a licensed land surveyor, engineer, or architect authorized by law to certify elevation information, and you performed the actual survey for a building in Zones A1-A30, PIE, All, A (with BEE), VL-V30, V. AR, ARIA, ARIA1-A30, AR'AE, AR/AH, or AR/AO, you must also complete Section D.
Check Item G2 if information is entered in Section E by the community for a building in Zone A (without a FEMA-issued or community-issued BEE) or Zone AO.
Check Item G3 if the information in Items G4-G9 has been completed for community floodplain management purposes to document the as-built lowest floor elevation of the building. Section C of the Elevation Certificate records the elevation of various building components but does not determine the lowest floor of the building or whether the building, as constructed, complies with the community's floodplain management ordinance. This must be done by the community. Items G4-09 provide a way to document these determinations.
Item G4. Permit Number. Enter the permit number or other identifier to key the Elevation Certificate to the permit issued for the building.
Item G5. Date Permit Issued. Enter the date the permit was issued for the building.
Item G6. Date Certificate of Compliance Issued. Enter the date that the Certificate of Compliance or Occupancy or similar written official documentation of as-built lowest floor elevation was issued by the community as evidence that all work authorized by the floodplain development permit has been completed in accordance with the community's floodplain management laws or ordinances.
Item G7. New Construction or Substantial Improvement. Check the applicable box. "Substantial Improvement means any reconstruction, rehabilitation, addition, or other improvement of a building, the cost of which equals or exceeds 50 percent of the market value of the building before the start of construction of the improvement. The term includes buildings that have incurred substantial damage, regardless of the actual repair work performed.
Item G8. As-built lowest floor elevation. Enter the elevation of the lowest floor (including basement) when the construction of the building is completed and a final inspection has been made to confirm that the building is built in accordance with the permit, the approved plans, and the community's floodplain management laws or ordinances. Indicate the elevation datum used.
Item G9. BEE. Using the appropriate FIRM panel, FIS, or other data source, locate the property and enter the BEE (or base flood depth) of the building site. Indicate the elevation datum used.
Enter your name, title, and telephone number, and the name of the community. Sign and enter the date in the appropriate blanks.
The following eight diagrams illustrate various types of buildings. Compare the features of the building being certified with the features shown in the diagrams and select the diagram most applicable. Enter the diagram number in Item C2 and the elevations in Items C3a-C3g.
In A zones, the floor elevation is taken at the top finished surface of the floor indicated; in V zones, the floor elevation is taken at the bottom of the lowest horizontal structural member (see drawing in instructions for Section C).
** An "opening" (flood vent) is defined as a permanent opening in a wall that allows for the free passage of water automatically in both directions without human intervention. Under the NFIP, a minimum of two openings is required for enclosures or crawl spaces with a total net area of not less than one square inch for every square foot of area enclosed. Each opening must be on different sides of the enclosed area. If a building has more than one enclosed area, each area must have openings on exterior walls to allow floodwater to directly enter. The bottom of the openings must be no higher than one foot above the grade underneath the flood vents. Alternatively, you may submit a certification by a register professional engineer or architect that will allow for the automatic equalization of hydrostatic flood forces on exterior walls. A window, a door, or a garage door is not considered an opening.
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