Note: The Coastal-A-Zone or V-Zone Design Certificate is not a substitute for the NFIP Elevation Certificate
(see Fact Sheet No. 1.4,
Lowest Floor Elevation), which is required to certify as-built elevations needed for flood insurance rating.
COASTAL-A-ZONE or V-ZONE DESIGN CERTIFICATE
Name Policy Number (Insurance Co. Use)
Building Address of Other Description
Permit No. City State Zip Code
SECTION I: Flood Insurance Rate Map (FIRM) Information
Community No. Panel No. Suffix FIRM Date FIRM Zone(s)
SECTION II: Elevation Information Used for Design
[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.]
1. FIRM Base Flood Elevation (BFE) .................................................................................................................................. ______feet*
2. Community’s Design Flood Elevation (DFE) .................................................................................................................... ______feet*
3. Elevation of the Bottom of Lowest Horizontal Structure Member .................................................................................... ______feet*
4. Elevation of Lowest Adjacent Grade ................................................................................................................................ ______feet*
5. Depth of Anticipated Scour/Erosion used for Foundation Design .................................................................................... ______feet
6. Embedment Depth of Pilings of Foundation Below Lowest Adjacent Grade ................................................................... ______feet
* Indicate elevation datum used in 1-4: NGVD29 NAVD88 Other
SECTION III: Coastal-A-Zone or V-Zone Design Certification Statement
I certify that: (1) I have developed or reviewed the structural design, plans, and specifications for construction of the above-
referenced building and (2) that the design and methods of construction specified to be used are in accordance with accepted
standards of practice** for meeting the following provisions:
The bottom of the lowest horizontal structural member of the lowest floor (excluding piles and columns) is elevated to or above
the BFE.
The pile and column foundation and structure attached thereto is anchored to resist flotation, collapse, and lateral movement due
to the effects of the wind and water loads acting simultaneously on all building components. Water loading values used are those
associated with the base flood***. Wind loading values used are those required by the applicable State or local building code. The
potential for scour and erosion at the foundation has been anticipated 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 engineer or architect when breakaway walls are designed to have a
resistance of more than 20 psf (0.96 kN/m2) determined using allowable stress design]
I certify that: (1) I have developed or reviewed the structural design, plans, and specifications for construction of breakaway walls to
be constructed under the above-referenced building and (2) that the design and methods of construction specified to be used are in
accordance with accepted standards of practice** for meeting the following provisions:
Breakaway wall collapse shall result from a water load less than that which would occur during the base flood***.
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 acting simultaneously on all building components (see Section III).
SECTION V: Certification and Seal
This certification is to be signed and sealed by a registered professional engineer or architect authorized by law
to certify structural designs. I certify the Coastal-A-Zone or V-Zone Design Certification Statement (Section III) and
________ the Breakaway Wall Design Certification Statement (Section IV, check if applicable).
Certifier’s Name License Number
Title Company Name
Address
City State Zip Code
Signature Date Telephone
PlaceSealHere
BALDWIN COUNTY BUILDING DEPARTMENT
www.BaldwinCountyAL.gov/departments/building-inspection
Bay Minette: 251-580-1886 * Fairhope: 251-990-4641 * Foley: 251-972-6837
click to sign
signature
click to edit
![]()
