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City of St. Petersburg
Planning & Development Services
Construction Services & Permitting
COASTAL A ZONE / V ZONE
DESIGN & CONSTRUCTION CERTIFICATE
For New Construction, Substantial Improvements, and the Repair
of Substantially Damaged Structures in Coastal High Hazard Areas and Coastal A Zones
Revised 03/28/2024
The City of St Petersburg requires Sections I through V of this form be completed by the design professional of
record and submitted with the permit application. Before a final building inspection may be scheduled, this form
must be completed by the design professional of record, including Section VI for the as-built condition, and
submitted to Construction Services and Permitting.
P
ermit Number__________________ Name_________________________________________________________
Building Address or Other Description_______________________________________________________________
City_________________________________________________ State______________ Zip Code______________
Legal Description of Lot __________________________________________________________________________
Date of Construction ____________________________ New Building Substantial Improvement
SECTION I: FLOOD INSURANCE RATE MAP (FIRM) DATA
Note: This section documents the elevations/depths used or specified in the design. It does not document surveyed
elevations and is not equivalent to the as-built elevations required to be submitted during or after construction.
C
ommunity Name & Number _____________________________________________________________________
FIRM Panel No. ___________ Panel Suffix __________ FIRM Index Date__________ FIRM Panel Date___________
Flood Zone(s) ____________ Base Flood Elevation(s) ______________ Coastal A Zone: Yes No
SECTION II: ELEVATION INFORMATION USED FOR DESIGN
Elevation of the bottom of the Lowest Horizontal Structural Member: _____________ Feet
Base Flood Elevation (BFE): _____________ Feet
_____________ Feet
_____________ Feet
____
_________ Feet
_____________ Feet
_____________ Feet
Elevation of Lowest Adjacent Grade (LAG):
Elevation of Highest Adjacent Grade (HAG):
Foundation type: Piling Shallow (Coastal A only)
Foundation Description:
Elevation at Bottom of Foundation
Approximate depth of scour/erosion used for foundation design
Embedment depth
of pilings or foundation below LAG
Datum used: NGVD 29 NAVD 88
Other ____________________________________
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SECTION III: COASTAL A ZONE / V ZONE DESIGN CERTIFICATION STATEMENT
NOTE: This section must be certified by a registered engineer or architect when breakaway walls are designed to
have a resistance of more than 20 psf (0.96kN/m2) determined using allowable stress design.
I certify that I have developed or reviewed the structural design, plans and specifications for construction, and that
the design and methods of construction are in accordance with accepted standards of engineering practice for
meeting the following provisions:
T
he bottom of the lowest horizontal structural member of the lowest floor (excluding piles and columns) is
elevated to above the Base Flood Elevation in accordance with requirements of the Florida Building Code,
ASCE 24, and local floodplain management regulations.
The pile or column foundation and building or structure attached thereto are anchored to resist flotation,
collapse, and lateral movement due to the effects of wind and water loads acting simultaneously on
all
s
tructure components. Water loading values used are those associated with the base flood. Wind loading
values used are those required by the Florida Building Code and local floodplain management regulations.
The potential long-term erosion and local scour for the foundation elements are determined and
incorporated in the design for conditions associated with the base flood, including wave action.
SECTION IV: BREAKAWAY WALL DESIGN CERTIFICATION STATEMENT
NOTE: This section must be certified by a registered professional engineer or architect who is authorized by law to
certify structural designs.
I
certify that I have developed or reviewed the structural design, plans and specifications for construction, and that
the proposed design and methods of construction to be used for the breakaway walls are in accordance with
accepted standards of engineering practice for meeting the following provisions:
Bre
akaway wall collapse shall result from a water load less than that which would occur during the base
flood; and
The elevated portion of the building and supporting foundation system shall not be subject to collapse,
displacement, or other structural damage due to the effects of wind and water loads action simultaneously
on all structure components (structural and nonstructural). The wind and water loading values to be used
are those defined in Section III.
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SECTION V: DESIGN CERTIFICATION AND SEAL
This certification is to be signed and sealed by a Florida licensed design professional architect or engineer
authorized by law to certify structural designs. I certify the Coastal A Zone /V Zone Design Certification Statement
in Section III and the Breakaway Wall Design Certification Statement in section IV (if applicable).
Cert
ifier’s Name (please print) ____________________
License number ________________________________
Title _________________________________________
Company Name__________________ ________
Address __________________________________
City___________________________________________
State _______________ Zip Code__________________
STAMP OR SEAL
Ema
il_______________________Phone_____________
SECTION VI: CONSTRUCTION CERTIFICATION AND SEAL
This certification is to be signed and sealed by a Florida licensed design professional architect or engineer
authorized by law to certify structural designs. I certify the structure, based upon development and/or review of
the design, specifications, as-built drawings for construction and physical inspection, has been designed and
constructed in accordance with Coastal A Zone /V Zone Design Certification Statement in Section III and the
Breakaway Wall Design Certification Statement in Section IV (if applicable) and any alterations also meet those
standards.
Certi
fier’s Name (please print) ____________________
License number ________________________________
Title _________________________________________
Company Name_________________________________
Add
ress_______________________________________
City___________________________________________
State _______________ Zip Code__________________
Email_______________________Phone_____________
STAMP OR SEAL
