Tie Beam Elevation Certificate

							                                                         Department of Environmental Resources Management
                                                                 Plan Review & Development Approvals Division
                                                                                           th
                                                                               11805 SW 26 Street, Suite 124
                                                                                         Miami, Florida 33175
www.miamidade.gov/derm                                                                        T 786-315-2800
                                                                              dermplanreview@miamidade.gov


                                     Tie Beam Elevation Certificate


 Process #: ___________________        Folio #: ___________________       Permit #: ___________________



 Address: ____________________________________________________________________________________



 Map Panel #:               Suffix FIRM Date:             Flood Zone:               Base Flood Elevation:

 ___________                _______________               __________                __________________




             Information by Surveyor Only                               For DERM Use Only

 Highest COR: _______________________________         Highest COR (from plans): __________________________

                       As Built
                                                                        Minimum Required
 Top of Bottom of Floor: _______________________

 Lowest Struct. Member: ______________________        Top of Bottom of Floor: _____________________________
 Attached Garage: ___________________________         Lowest Struct. Member: ____________________________
 Lowest Adj. Grade: __________________________        Attached Garage: _________________________________
 As Built Elevations Certified By:                    Lowest Adj. Grade: ________________________________
 Surveyor’s Name: ___________________________

 License #: _________________________________                            DERM Comment
 Address: __________________________________
                                                      In Compliance:    Yes         No
 Phone #: __________________________________
                                                      Inspection:       Yes         No

                                                      Hold Released:    Yes         No
                          Seal
                                                      Released by: ____________________________________
                          Date
                                                      QC by: _________________________________________
                       Signature