Surveying Form

Free Fillable Flood Elevation Certificate

Fill out this flood elevation certificate online and download as PDF - free, no signup required.

LS-0833 fieldscompliance

Property Information

Property Address*

Community Name*

NFIP Community Number*

Map Panel Number*

Map Date (Effective / Revised)*

Flood Zone Designation*

Property Owner

Building Information

Building Type*

Building Use*

Number of Floors*

Foundation Type*

Building Diagram Number

FEMA Elevation Certificate diagram number that best represents the building

Elevation Data

Vertical Datum*

Benchmark Description*

Benchmark Elevation (ft)*

Top of Bottom Floor Elevation (ft)*

Elevation of the top of the lowest floor including basement, crawlspace, or enclosure

Top of Next Higher Floor Elevation (ft)

Elevation of the top of the next higher floor above the bottom floor

Bottom of Lowest Horizontal Structural Member (ft)

For buildings on pilings, posts, piers, or crawlspace foundations

Attached Garage Top of Slab (ft)

Top of floor elevation of attached garage

Lowest Adjacent Grade Elevation (ft)*

Lowest natural grade elevation adjacent to the building

Highest Adjacent Grade Elevation (ft)*

Highest natural grade elevation adjacent to the building

Lowest Elevation of Machinery / Equipment (ft)

HVAC, electrical, plumbing, or other machinery serving the building

Flood Zone Data

Base Flood Elevation — BFE (ft)

From FIRM or FIS for the building location

SFHA Zone

Within Coastal Barrier Resources System (CBRS)

Within CRS Community

Community Rating System participation

Flood Insurance Rate Zone

Certification

Certifier Name*

License / Registration Number*

Certification Date*

Company Name

Certification Notes / Comments

Photo Documentation

Location

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Related Compliance Forms

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LS-09