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PENNSYLVANIA
PROPERTY INFORMATION
Building Owners Name _______________________________________________
Property Address _______________________________________________
_______________________________________________
City ___________________________ State PA Zip Code _____________
Has a certified elevation been completed for this property? YES _______ NO _______
If yes, please attach. If no complete the following section:
FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Community Name ___________________________________________________________
Community Number ___________________________________________________________
(Panel Number/Suffix)
Date of FIRM _____________ FIRM Zone ______________ Base Flood Elevation ____________
Determination of Building Market Value
Building Market Value (BMV) may be determined using various methods. Only the value of the building itself must be determined. The value of other site improvements such as landscaping, pavement, pools and detached buildings do not need to be included.
Acceptable methods of estimating building market value include:
independent appraisals by a professional appraiser
property appraisals used for tax purposes (adjusted Assessment Value used as a screening tool)
the value of the building based of insurance claims
qualified estimates based on sound professional judgment made by staff of the local Codes Officer, or local or state tax assessors office
Substantial Damage Determination Worksheet
(Total $ Cost of Repairs) = _______________
____________________________________________ = _______________ Percent (%) Damaged
(Building Market Value) = _______________
In the event that the Percent Damaged is equal to or greater than 50%, the building is substantially damaged.
Certified by _____________________________________________ Date ____________________
(Print Name)
Signature ______________________________________________
Title ______________________________________________
Municipality ______________________________________________
Comments:
____________________________________________________________________________________________________________________________________________________________________________________________________________
5/2010 PEMA HMGP Application A-10 Substantial Damage Determination Worksheet
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