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785 BAY ESPLANADE . � U.S.,�JEPAR;MENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 Expires Februarv 28.2009 Federal Emergency Management Agency National Fiood Insurance Program Important: Read the instructions on pages 1-8. � SECTION A-PROPERTY INFORMATION or insurance Company Use: A1. Building Owner's Name LANNY 8�VICKI JACKSON Policy Number A2. Building Street Address(including Apt., Unit,Suife,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number 785 BAY ESPLANADE City CLEARWATER BEACH State FL ZIP Code33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Descriptio ,etc.) LOT 10 BLOCK 38 "MANDALAY" PLAT BOOK 14 PAGES 32-35 �s?��L f(�66�/Q�f/D�Q� A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude: Lat.27°59'36"N Long.82°49'26"W Horizontal Datum:❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number8 A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) 1310sq ft a) Square footage of attached garage 543 sq ft b) Ivo.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)wails within 1.0 foot above adjacent grade 6 walls within 1.0 foot above adjacent grade 0 c) Total net area of flood o enin s in A8.b 758 s in c) Total net area of flood o enin s in A9.b 0 sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number 62.County Name B3.State CITY OF CLEARWATER 125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Suffix 66.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) 12103C0102G G MAY 17,2005 SEPT.3,2003 AE 11 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑Community Determined ❑Other(Describe) 611. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation DateNONE ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings" ❑ Building Under Construction" �Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized CLWTR.BM"J-2"EL=4.32'Vertical Datum NAVD88 ConversionlComments NGVD29-0.86FT. =NAVD88 Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure fioor)_ 6.5 �feet ❑meters(Puerto Rico oniy) b) Top of the next higher floor 16.0 �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico oniy) d) Attached garage(top of slab) 4.9 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) � Lowest adjacent(finished)grade(LAG) 4.1 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 5.1 �feet ❑meters(Puerto Rico only) SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ,,�-r , Y information. I certify that the information on this Certificate represents my best efforts to interpret the data available. ' I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Y.��7 1��(` ` x' � �� , - � Check here if comments are provided on back of form. �,�,�� ' G , .w Certifier's Name MICHAEL J.BAKER License Number LS 4086 � `�;�wf�, ,, ��' ' Title LAND SURVEYOR Company Name MICHAEL BAKER ASSOCIATES �� `f+s i�� ;` + ,r ��,-," Address 220 S.SAFFORp AV�. City TARPON SPRWGS State FL ZIP Code 34689 ,�j �� ) �%pa�{�� .. 3 = .1 /� ��/ }e� �L.R��' . Signature ;' ,� , �__ Date NOV.4,2008 Telephone 727-938-5026 ` j FEM orm 81-31, bruary 2006 See reverse side for continuation. Replaces all previous editions l r , IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Comp�r�y Use; . Building Street Address(including Apt., Unit,Suite,and/or Bidg. No.)or P.O. Route and Box No. Policy Number 785 BAY ESPLANADE ' City CLEARWATER BEACH StateFLZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agenUcompany,and(3)building owner. Comments C2(e). AIR CONDITIONING CONDENSOR. (BOTfOM OF ELECTRIC METER BOX=8.4). ,�%' / ' Signature Date � ;;�.�,.-'� -�i �� Nov. 4 2008 ' ❑ Check here if attachments �TION E-BUNCDIN� ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A, B, and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(inciuding basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of siab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B, and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G -COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community o�cial completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The foliowing information(Items G4.-G9.)is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(inciuding basement)of the building: _❑feet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum Local Official's Name Title Corrirnunity Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions . � , , . Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poi�cy Number 785 Bay Esplanade City State ZIP COd@ Company NAIC Number Clearwater B 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, ' following. � �� . �' , � � ,_ _ ; �_, _ �� 'r � � ' �� , �!� , � '��_ � � t " �,��i � - � � , � �� . � �: �, ; �; � �: � I �, ,� � � � �- , � _ � � 4 , , �� 1 , _ � � �; , � � '� ' - �; � ti � , T r. . . _._. . � _. '" �' � . ___-'"._ � ` � � I `� r�� - � . i`s. �� l�� . „ , � ...� .. � :, xw�s�'— �.� � ;�..�� w�." __ .___ - �,� _ � � � - � �� `� � ■ � � ,�� .. - s�a ° 1 � ��. � i a '� — ( � _ .�� — � t , _ � � � _- I� , .� �.��..�:_ . ~:,�-y. '� � _ :;,.,�:A .......-=�-��,: , c;` .C � � E ° ° , ^ . - FRONT VT�W �� '�''''�''�� REAR VIEW �,., , , > /,� �\ s�,°+ ��'� � (/ `, � ��_. r � � � �_ .� _